Healthcare Provider Details

I. General information

NPI: 1750973954
Provider Name (Legal Business Name): SYNERGY COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3977 CRAWFORD CT
LOVELAND CO
80538-5595
US

IV. Provider business mailing address

PO BOX 2362
LOVELAND CO
80539-2362
US

V. Phone/Fax

Practice location:
  • Phone: 970-232-5122
  • Fax:
Mailing address:
  • Phone: 970-232-5122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: VIDA A MENDEZ
Title or Position: PRESIDENT
Credential: LCSW, CAC II
Phone: 970-232-5122