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General NPI Number Information
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NPI Number | 1174277586
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Entity Type | Organization
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Legal Business Name | RENNEWANZ-REEVES COUNSELING LLC
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Dates
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Enumeration Date | 02/05/2022
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 700 BELFORD AVE STE 102
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-3171
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Country | US
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Telephone | 970-812-3780
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Fax |
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Provider Business Mailing Address
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Address Line | 424 AMETHYST DR
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City | FRUITA
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State | CO
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Zip | 81521-8813
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Country | US
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Telephone | 970-812-3780
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MRS. KANDISE NICOLE MCCOY
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Credential | LPC, LAC
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Telephone | 970-812-3780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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