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General NPI Number Information
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NPI Number | 1053978049
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Entity Type | Organization
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Legal Business Name | NURTURED SELF COUNSELING, LLC
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Dates
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Enumeration Date | 05/24/2019
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 2855 N SPEER BLVD STE C
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City | DENVER
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State | CO
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Zip | 80211-4240
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Country | US
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Telephone | 720-650-4122
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Fax |
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Provider Business Mailing Address
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Address Line | 2855 N SPEER BLVD STE C
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City | DENVER
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State | CO
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Zip | 80211-4240
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Country | US
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Telephone | 720-650-4122
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBEKKAH GOODHART
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Credential | LCSW
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Telephone | 720-650-4122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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