MEDICARE: HEART OF LIFE 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	101YP2500X	Professional Counselor	11759	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346627072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART OF LIFE COUNSELING LLC

Provider Business Mailing Address
First Line	:	7995 E MISSISSIPPI AVE
Second Line	:	J3
City	:	DENVER
State	:	CO
Zip	:	80247-2015
Country	:	US
Telephone Number	:	720-226-6731
Fax Number	:	303-322-1087

Provider Business Practice Location Address
First Line	:	3600 S BEELER ST STE 340
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80237-1801
Country	:	US
Telephone Number	:	720-226-6731
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	BRENDA ARIEL SMITH
Credential	:	LPC
Telephone Number	:	720-226-6731

Provider Enumeration Date	:	05/01/2015
Last Update Date	:	11/07/2019

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Directions to “HEART OF LIFE COUNSELING LLC ” Practice Location

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