=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558831602
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUEST COUNSELING SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2018
-----------------------------------------------------
Last Update Date | 06/02/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8461 TURNPIKE DR STE 207
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80031-4379
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-578-8320
-----------------------------------------------------
Fax | 303-590-9627
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5023 W 120TH AVE STE 304
-----------------------------------------------------
City | BROOMFIELD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80020-5606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-578-8320
-----------------------------------------------------
Fax | 303-590-9627
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINIC DIRECTOR/OWNER
-----------------------------------------------------
Name | LELA HARRISON
-----------------------------------------------------
Credential | LCSW, LAC, MAC
-----------------------------------------------------
Telephone | 303-578-8320
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------