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General NPI Number Information
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NPI Number | 1639614092
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Entity Type | Organization
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Legal Business Name | INTO THE WOODS COUNSELING, INC.
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 7009 S. POTOMAC ST. SUITE 102
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City | CENTENNIAL
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State | CO
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Zip | 80112-4034
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Country | US
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Telephone | 720-213-6180
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 N. LOGAN ST. APT. 302
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City | DENVER
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State | CO
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Zip | 80203-2464
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Country | US
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Telephone | 720-585-5110
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Fax |
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Authorized Official
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Title or Position | LPC/OWNER
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Name | KRISTIN KAYE SEARCEY
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Credential | LPC
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Telephone | 720-585-5110
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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 | 0012993
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License Number State | CO
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