MEDICARE: MOMENTUM COUNSELING AND CONSULTING LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	106H00000X	Marriage & Family Therapist
3	101YM0800X	Mental Health Counselor
4	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1336821743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOMENTUM COUNSELING AND CONSULTING LLC

Provider Business Mailing Address
First Line	:	2120 MILESTONE DR STE 103
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5761
Country	:	US
Telephone Number	:	970-829-8780
Fax Number	:	970-341-2074

Provider Business Practice Location Address
First Line	:	4770 BASELINE RD STE 244
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80303-2666
Country	:	US
Telephone Number	:	970-829-8780
Fax Number	:	970-341-2074

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	DAMOND DOTSON
Credential	:
Telephone Number	:	970-829-8780

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	03/28/2026

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