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NPI Code Detail

MEDICARE: HEART CENTERED COUNSELING, PC

MEDICARE: HEART CENTERED COUNSELING, PC
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
1101YP2500XProfessional Counselor
2103TC0700XClinical Psychologist
31041C0700XClinical Social Worker
4106H00000XMarriage & Family Therapist
52084P0800XPsychiatry Physician
6363LP0808XPsychiatric/Mental Health Nurse Practitioner
7101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578189155
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEART CENTERED COUNSELING, PC
Provider Business Mailing Address
First Line : 215 W OAK ST FL 4
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-2734
Country : US
Telephone Number : 970-310-3406
Fax Number :
Provider Business Practice Location Address
First Line : 1661 ESTRELLA AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80538-3522
Country : US
Telephone Number : 970-310-3406
Fax Number :
Authorized Official
Title or Position : CHIEF LEGAL OFFICER
Name : RYAN PARDO
Credential :
Telephone Number : 206-399-1493
Provider Enumeration Date : 06/19/2020
Last Update Date : 04/24/2024

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