MEDICARE: STAND TALL COUNSELING

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	11497	CO

General Provider Information

NPI Number	:	1811382161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAND TALL COUNSELING

Provider Business Mailing Address
First Line	:	1556 WILLIAMS STREET
Second Line	:	UNIT 201
City	:	DENVER
State	:	CO
Zip	:	80218
Country	:	US
Telephone Number	:	303-656-9246
Fax Number	:

Provider Business Practice Location Address
First Line	:	1556 N WILLIAMS ST
Second Line	:	UNIT 201
City	:	DENVER
State	:	CO
Zip	:	80218-1661
Country	:	US
Telephone Number	:	303-656-9246
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	JILL A CARSTENS
Credential	:	MA
Telephone Number	:	303-928-0554

Provider Enumeration Date	:	04/03/2015
Last Update Date	:	04/03/2015

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Directions to “STAND TALL COUNSELING ” Practice Location

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