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General NPI Number Information
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NPI Number | 1912832833
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Entity Type | Organization
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Legal Business Name | SAN JUAN PSYCHOTHERAPY
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Dates
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Enumeration Date | 06/13/2026
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Last Update Date | 06/13/2026
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Provider Practice Location Address
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Address Line | 870 CHIPETA DR
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City | RIDGWAY
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State | CO
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Zip | 81432-9358
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Country | US
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Telephone | 970-626-8380
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2352
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City | TELLURIDE
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State | CO
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Zip | 81435-2352
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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 | OWNER
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Name | GLENYS HUNT
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Credential | LPCC
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Telephone | 410-790-1077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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