Healthcare Provider Details

I. General information

NPI: 1164269254
Provider Name (Legal Business Name): ASPEN COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 COFFMAN ST STE 203
LONGMONT CO
80501-4974
US

IV. Provider business mailing address

636 COFFMAN ST STE 203
LONGMONT CO
80501-4974
US

V. Phone/Fax

Practice location:
  • Phone: 303-834-7389
  • Fax:
Mailing address:
  • Phone: 303-834-7389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANELLE ROTTNER
Title or Position: CLINICAL DIRECTOR, THERAPIST
Credential: MA, LPC
Phone: 720-541-8806