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General NPI Number Information
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NPI Number | 1184257040
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Entity Type | Organization
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Legal Business Name | FEEL AWESOMER, LLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 374 LOCALS LANE
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City | BRECKENRIDGE
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State | CO
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Zip | 80424-8042
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Country | US
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Telephone | 970-333-9622
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9694
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City | BRECKENRIDGE
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State | CO
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Zip | 80424-9016
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Country | US
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Telephone | 970-333-9622
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Fax |
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Authorized Official
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Title or Position | OWNE/COUNSELOR
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Name | ANDREW WILLIAM MIKITA
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Credential | LPC
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Telephone | 970-333-9622
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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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