MEDICARE: ASU COUNSELING 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	305S00000X	Point of Service
2	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D1063467953	OTHER	CO	PERSONAL BUSINESS

General Provider Information

NPI Number	:	1134841786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASU COUNSELING LLC

Provider Business Mailing Address
First Line	:	14621 COUNTY ROAD 18
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-8413
Country	:	US
Telephone Number	:	316-640-8823
Fax Number	:

Provider Business Practice Location Address
First Line	:	14621 COUNTY ROAD 18
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-8413
Country	:	US
Telephone Number	:	316-640-8823
Fax Number	:

Authorized Official
Title or Position	:	CLINICIAN/OWNER
Name	:	MS. AMY ELIZABETH UNREIN
Credential	:	LCSW
Telephone Number	:	316-640-8823

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	07/25/2023

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Directions to “ASU COUNSELING LLC ” Practice Location

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