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General NPI Number Information
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NPI Number | 1578064291
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Entity Type | Organization
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Legal Business Name | GROWING MINDS COUNSELING LLC
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 609 W LITTLETON BLVD STE 309
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City | LITTLETON
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State | CO
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Zip | 80120-2352
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Country | US
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Telephone | 720-619-0838
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Fax |
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Provider Business Mailing Address
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Address Line | 10527 W DARTMOUTH AVE
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City | LAKEWOOD
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State | CO
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Zip | 80227-5607
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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 | CLINICIAN/OWNER
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Name | CHRISTINE JACKSON COLE
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Credential | LCSW
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Telephone | 720-619-0838
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09924067
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License Number State | CO
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