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NPI Code Detail

MEDICARE: RESTORATION HOPE COUNSELING AND NEUROFEEDBACK, PLLC

MEDICARE: RESTORATION HOPE COUNSELING AND NEUROFEEDBACK, 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1629610605
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORATION HOPE COUNSELING AND NEUROFEEDBACK, PLLC
Provider Business Mailing Address
First Line : 6901 S PIERCE ST STE 370
Second Line :
City : LITTLETON
State : CO
Zip : 80128-7202
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6901 S PIERCE ST STE 370
Second Line :
City : LITTLETON
State : CO
Zip : 80128-7202
Country : US
Telephone Number : 303-775-3684
Fax Number :
Authorized Official
Title or Position : OWNER
Name : BETHANY WILSN
Credential : MA, LPC, BCN, NCC
Telephone Number : 636-699-7864
Provider Enumeration Date : 10/11/2019
Last Update Date : 02/19/2020

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Directions to “RESTORATION HOPE COUNSELING AND NEUROFEEDBACK, PLLC ” Practice Location

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