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General NPI Number Information
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NPI Number | 1568851475
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Entity Type | Organization
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Legal Business Name | ST. EPHRAIM CENTER
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 9300 W DARTMOUTH PL
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City | LAKEWOOD
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State | CO
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Zip | 80227-4407
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Country | US
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Telephone | 720-943-0840
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Fax |
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Provider Business Mailing Address
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Address Line | 9300 W DARTMOUTH PL
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City | LAKEWOOD
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State | CO
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Zip | 80227-4407
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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 | EXECUTIVE DIRECTOR
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Name | MASHA GISETTI
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Credential |
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Telephone | 303-358-1360
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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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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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