Healthcare Provider Details

I. General information

NPI: 1851022511
Provider Name (Legal Business Name): MT COUNSELING & CONSULTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10750 IRMA DR UNIT 18
NORTHGLENN CO
80233-3631
US

IV. Provider business mailing address

10750 IRMA DR UNIT 18
NORTHGLENN CO
80233-3631
US

V. Phone/Fax

Practice location:
  • Phone: 307-399-6273
  • Fax:
Mailing address:
  • Phone: 307-399-6273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAELA TRATOS
Title or Position: OWNER
Credential: MS, LPC, NCC
Phone: 307-399-6273