MEDICARE: SALITA COUNSELING PLLC

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

General Provider Information

NPI Number	:	1437931664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALITA COUNSELING PLLC

Provider Business Mailing Address
First Line	:	12744 W ILIFF AVE
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-4332
Country	:	US
Telephone Number	:	303-941-0461
Fax Number	:

Provider Business Practice Location Address
First Line	:	4251 KIPLING ST UNIT 345
Second Line	:
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-2898
Country	:	US
Telephone Number	:	303-941-0461
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHERINE LABORE
Credential	:	LPC, LAC
Telephone Number	:	303-941-0461

Provider Enumeration Date	:	10/23/2023
Last Update Date	:	10/23/2023

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