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General NPI Number Information
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NPI Number | 1659749299
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Entity Type | Organization
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Legal Business Name | MICHELLE CHRASTIL COUNSELING LLC
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 5650 GREENWOOD PLAZA BLVD SUITE 141
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2307
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Country | US
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Telephone | 303-669-0893
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Fax |
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Provider Business Mailing Address
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Address Line | 5650 GREENWOOD PLAZA BLVD SUITE 141
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2307
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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 | SUPERVISOR CEO
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Name | MICHELLE NICOLE CHRASTIL
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Credential | LPC
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Telephone | 303-669-0893
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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 | LPC0011936
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC0011936
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC0011936
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 11191
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License Number State | CO
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