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General NPI Number Information
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NPI Number | 1477006450
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Entity Type | Organization
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Legal Business Name | MANTIS COUNSELING AND COACHING SERVICES
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 1544 YORK ST
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City | DENVER
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State | CO
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Zip | 80206-1442
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Country | US
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Telephone | 720-394-1437
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Fax |
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Provider Business Mailing Address
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Address Line | 1544 YORK ST
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City | DENVER
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State | CO
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Zip | 80206-1442
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Country | US
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Telephone | 720-394-1437
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | REBECCA BRINGEWATT
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Credential | LPC
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Telephone | 720-394-1437
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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 | 4768
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4686
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License Number State | CO
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