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General NPI Number Information
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NPI Number | 1619895166
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Entity Type | Organization
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Legal Business Name | SAMANTHA M CHARYTONIUK
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 189 COUNTY ROAD 253
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City | DURANGO
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State | CO
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Zip | 81301-7426
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Country | US
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Telephone | 970-310-4006
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Fax |
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Provider Business Mailing Address
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Address Line | 189 COUNTY ROAD 253
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City | DURANGO
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State | CO
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Zip | 81301-7426
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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 | OWNER
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Name | SAMANTHA CHARYTONIUK
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Credential | LPC
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Telephone | 970-310-4006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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