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General NPI Number Information
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NPI Number | 1689951725
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Entity Type | Organization
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Legal Business Name | CRAZY WISDOM JOURNEY, LLC
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 07/20/2019
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Provider Practice Location Address
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Address Line | 5921 MIDDLEFIELD RD STE 100
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City | LITTLETON
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State | CO
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Zip | 80123-2860
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Country | US
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Telephone | 303-515-0987
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Fax | 720-726-7745
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Provider Business Mailing Address
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Address Line | 5921 MIDDLEFIELD RD STE 100
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City | LITTLETON
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State | CO
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Zip | 80123-2860
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Country | US
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Telephone | 303-515-0987
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Fax | 720-726-7745
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DEBRA VELETA FOSTER
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Credential | MAC, LAC, LPC-MHSP
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Telephone | 303-515-0987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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 #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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