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NPI Code Detail

MEDICARE: JADE COOLEY THERAPY LLC

MEDICARE: JADE COOLEY THERAPY 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1356029078
Entity Type Code : Organization
Provider Name (Legal Business Name) : JADE COOLEY THERAPY LLC
Provider Business Mailing Address
First Line : 2150 W 29TH AVE STE 135
Second Line :
City : DENVER
State : CO
Zip : 80211-3869
Country : US
Telephone Number : 720-263-7194
Fax Number :
Provider Business Practice Location Address
First Line : 2150 W 29TH AVE STE 135
Second Line :
City : DENVER
State : CO
Zip : 80211-3869
Country : US
Telephone Number : 720-263-7194
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JADE COOLEY
Credential : LPC
Telephone Number : 504-952-2602
Provider Enumeration Date : 07/11/2023
Last Update Date : 08/01/2023

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Directions to “JADE COOLEY THERAPY LLC ” Practice Location

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