MEDICARE: STRUGGLE OF LOVE FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker
3	261QM0850X	Adult Mental Health Clinic/Center
4	261QM0855X	Adolescent and Children Mental Health Clinic/Center
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1881372043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRUGGLE OF LOVE FOUNDATION

Provider Business Mailing Address
First Line	:	12000 E 47TH AVE STE 403A
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-3143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12000 E 47TH AVE STE 403A
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-3143
Country	:	US
Telephone Number	:	720-923-6122
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST SUPERVISOR
Name	:	BETSY CHANTHAPASEUTH
Credential	:	LCSW
Telephone Number	:	720-923-6122

Provider Enumeration Date	:	07/07/2023
Last Update Date	:	07/07/2023

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Directions to “STRUGGLE OF LOVE FOUNDATION ” Practice Location

Language	Start Address	Practice Location

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