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General NPI Number Information
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NPI Number | 1629342779
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Entity Type | Organization
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Legal Business Name | BREAKTHROUGH COUNSELING CENTER
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 8420 S CONTINENTAL DIVIDE RD STE 222
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City | LITTLETON
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State | CO
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Zip | 80127-4251
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Country | US
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Telephone | 720-229-3542
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Fax | 303-557-6195
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Provider Business Mailing Address
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Address Line | PO BOX 271562
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City | LITTLETON
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State | CO
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Zip | 80127-0027
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Country | US
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Telephone | 720-229-3542
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Fax | 303-557-6195
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | GRANT TSCHETTER
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Credential | MA, LPC
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Telephone | 720-229-3542
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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 | 3331
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License Number State | CO
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