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General NPI Number Information
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NPI Number | 1720681927
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Entity Type | Organization
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Legal Business Name | URBAN COLLECTIVE COUNSELING LLC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 1229 W 10TH AVE
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City | DENVER
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State | CO
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Zip | 80204-3905
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Country | US
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Telephone | 720-908-5050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40033
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City | DENVER
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State | CO
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Zip | 80204-0033
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Country | US
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Telephone | 720-908-5050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMIKA D THOMAS
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Credential | LPC
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Telephone | 720-908-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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