MEDICARE: SIMPLY BEING PSYCHOTHERAPY, PLLC

Medicare Provider Information

Scope of Practice

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

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

General Provider Information

NPI Number	:	1538826045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLY BEING PSYCHOTHERAPY, PLLC

Provider Business Mailing Address
First Line	:	2835 W 24TH AVE APT 209
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-4861
Country	:	US
Telephone Number	:	720-468-7161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1554 N EMERSON ST # 7
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1450
Country	:	US
Telephone Number	:	720-468-7161
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GRETCHEN KOENIG
Credential	:	LMFT
Telephone Number	:	720-468-7161

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	11/18/2021

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