=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932652674
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RHEMA THERAPEUTIC COUNSELING AND CONSULTING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2016
-----------------------------------------------------
Last Update Date | 05/09/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 324 E RAILROAD AVE 400
-----------------------------------------------------
City | FORT MORGAN
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80701-3145
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-585-1295
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 891
-----------------------------------------------------
City | BRUSH
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80723-0891
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-585-1295
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOCIAL WORKER
-----------------------------------------------------
Name | APRIL THOMAS-KENNEY
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 720-585-1295
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CSW-1480
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------