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General NPI Number Information
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NPI Number | 1407678956
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Entity Type | Organization
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Legal Business Name | PROGRESS MENTAL HEALTH, PLLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3524 S NELSON CIR UNIT 2-207
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City | LAKEWOOD
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State | CO
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Zip | 80235-1212
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Country | US
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Telephone | 973-647-5558
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Fax |
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Provider Business Mailing Address
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Address Line | 9878 W BELLEVIEW AVE # 5167
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City | DENVER
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State | CO
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Zip | 80123-2101
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Country | US
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Telephone | 973-647-5558
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLENN TYSON
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Credential | LPC
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Telephone | 973-647-5558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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