=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912442948
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DREAMS UNBOUND COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2016
-----------------------------------------------------
Last Update Date | 12/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3035 W 25TH AVE
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80211-4635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-235-8260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 735 ELATI ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80204-4537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-235-8260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | LEAH HUGHES-LIEBERT
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 720-235-8260
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFT.0001115
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------