MEDICARE: NANCY ORTIZ MORENO MA, LAC, ADVTP, ATP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACC-0020821	CO

General Provider Information

NPI Number	:	1972921039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY ORTIZ MORENO MA, LAC, ADVTP, ATP

Provider Business Mailing Address
First Line	:	2560 W 29TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-3712
Country	:	US
Telephone Number	:	303-477-8280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2370 W ALAMEDA AVE UNIT 8
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80223-1991
Country	:	US
Telephone Number	:	303-477-8280
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2014
Last Update Date	:	10/29/2024

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