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NPI 1962097832

NPI 1962097832 : ASSERTIVE LLC : LAKEWOOD, CO

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General NPI Number Information
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    NPI Number           |    1962097832
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    Entity Type          |    Organization 
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    Legal Business Name  |    ASSERTIVE LLC 
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Dates
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    Enumeration Date     |    03/03/2021
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    Last Update Date     |    03/03/2021
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Provider Practice Location Address
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    Address Line         |    6655 W JEWELL AVE 
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    City                 |    LAKEWOOD
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    State                |    CO
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    Zip                  |    80232-7190
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    Country              |    US
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    Telephone            |    303-912-4055
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 746071 
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    City                 |    ARVADA
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    State                |    CO
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    Zip                  |    80006-6071
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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    |    THERAPIST
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    Name                 |     JOHN  CUPICH 
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    Credential           |    
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    Telephone            |    303-912-4055
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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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Taxonomy #2
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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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