MEDICARE: CENTER FOR VALUED LIVING PLLC

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1033885587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR VALUED LIVING PLLC

Provider Business Mailing Address
First Line	:	2620 S PARKER RD STE 185
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-1626
Country	:	US
Telephone Number	:	720-347-8559
Fax Number	:

Provider Business Practice Location Address
First Line	:	3008 FOLSOM ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-2838
Country	:	US
Telephone Number	:	720-347-8559
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ALYSSA GRIFFITHS
Credential	:
Telephone Number	:	720-347-8559

Provider Enumeration Date	:	08/16/2021
Last Update Date	:	08/19/2021

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