MEDICARE: MILE HIGH COUNSELING AND CONSULTING, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1306492780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILE HIGH COUNSELING AND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	1250 S PARKER RD STE 202
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2178
Country	:	US
Telephone Number	:	303-641-7617
Fax Number	:	866-688-8087

Provider Business Practice Location Address
First Line	:	1250 S PARKER RD STE 202
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2178
Country	:	US
Telephone Number	:	303-641-7617
Fax Number	:	866-688-8087

Authorized Official
Title or Position	:	OWNER/CLINICIAN
Name	:	MS. KRISTIN NICOLE GEARHART
Credential	:	MA, LPC
Telephone Number	:	303-641-7617

Provider Enumeration Date	:	08/12/2019
Last Update Date	:	08/12/2019

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