MEDICARE: MONICA ROWELL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	12332	CO

General Provider Information

NPI Number	:	1013267749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONICA ROWELL LLC

Provider Business Mailing Address
First Line	:	4115 BOARDWALK DR
Second Line	:	SUITE 100
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5945
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4115 BOARDWALK DR
Second Line	:	SUITE 100
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5945
Country	:	US
Telephone Number	:	970-493-4580
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MONICA ROWELL
Credential	:	M.A., LPC
Telephone Number	:	970-672-6417

Provider Enumeration Date	:	09/10/2012
Last Update Date	:	10/19/2016

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