MEDICARE: ASTRAEA COUNSELING SERVICES

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	251S00000X	Community/Behavioral Health Agency	0009921039	CO

General Provider Information

NPI Number	:	1811441447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTRAEA COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	3827 PRECISION DR
Second Line	:	UNIT A
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-4597
Country	:	US
Telephone Number	:	970-232-8236
Fax Number	:

Provider Business Practice Location Address
First Line	:	3827 PRECISION DR
Second Line	:	UNIT A
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-4597
Country	:	US
Telephone Number	:	970-232-8236
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	REBECCA SCHUTZ
Credential	:
Telephone Number	:	970-232-8236

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	08/11/2016

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