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NPI Code Detail

MEDICARE: HEART WILD

MEDICARE: HEART WILD
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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor
3101Y00000XCounselor

General Provider Information

NPI Number : 1871289967
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEART WILD
Provider Business Mailing Address
First Line : 4704 HARLAN ST STE 511
Second Line :
City : DENVER
State : CO
Zip : 80212-7427
Country : US
Telephone Number : 720-635-9045
Fax Number :
Provider Business Practice Location Address
First Line : 4704 HARLAN ST STE 511
Second Line :
City : DENVER
State : CO
Zip : 80212-7427
Country : US
Telephone Number : 720-635-9045
Fax Number :
Authorized Official
Title or Position : OWNER/THERAPIST
Name : SARAH MURRAY
Credential :
Telephone Number : 720-635-9045
Provider Enumeration Date : 04/12/2023
Last Update Date : 11/18/2024

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Directions to “HEART WILD ” Practice Location

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