Healthcare Provider Details

I. General information

NPI: 1306443718
Provider Name (Legal Business Name): DOUGLAS COUNTY CHRISTIAN COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 MILLER ROAD
PARKER CO
80138
US

IV. Provider business mailing address

9030 MILLER ROAD
PARKER CO
80138
US

V. Phone/Fax

Practice location:
  • Phone: 303-840-5139
  • Fax: 303-841-2076
Mailing address:
  • Phone: 303-840-5139
  • Fax: 303-841-2076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DARRIN WILLIAM KESSLER
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC
Phone: 303-841-2076