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General NPI Number Information
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NPI Number | 1245020890
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Entity Type | Organization
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Legal Business Name | DECOOK MENTAL HEALTH SERVICES, PLLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 5420 WARD RD
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City | ARVADA
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State | CO
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Zip | 80002-1833
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Country | US
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Telephone | 408-673-1906
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Fax |
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Provider Business Mailing Address
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Address Line | 4520 CENTENNIAL BLVD # 1098
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-3335
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | RYAN DECOOK
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Credential | LCSW
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Telephone | 408-673-1906
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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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