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NPI Code Detail

MEDICARE: PENNOCK CENTER FOR COUNSELING

MEDICARE: PENNOCK CENTER FOR 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
1251V00000XVoluntary or Charitable AgencyCO

General Provider Information

NPI Number : 1912143470
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENNOCK CENTER FOR COUNSELING
Provider Business Mailing Address
First Line : 211 S 21ST AVE
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-2581
Country : US
Telephone Number : 303-655-9065
Fax Number : 303-655-0336
Provider Business Practice Location Address
First Line : 211 S 21ST AVE
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-2581
Country : US
Telephone Number : 303-655-9065
Fax Number : 303-655-0336
Authorized Official
Title or Position : DIRECTOR
Name : JODY PIERCE
Credential : LCSW
Telephone Number : 303-655-9065
Provider Enumeration Date : 01/05/2009
Last Update Date : 01/05/2009

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Directions to “PENNOCK CENTER FOR COUNSELING ” Practice Location

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