MEDICARE: COUNSELING SERVICE ASSOCIATES

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	19981128644	CO

General Provider Information

NPI Number	:	1992998041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING SERVICE ASSOCIATES

Provider Business Mailing Address
First Line	:	1037 ROBERTSON ST
Second Line	:
City	:	FT COLLINS
State	:	CO
Zip	:	80524-3926
Country	:	US
Telephone Number	:	970-493-3833
Fax Number	:	970-493-4333

Provider Business Practice Location Address
First Line	:	1037 ROBERTSON ST
Second Line	:
City	:	FT COLLINS
State	:	CO
Zip	:	80524-3926
Country	:	US
Telephone Number	:	970-493-3833
Fax Number	:	970-493-4333

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MICHAEL KEHL
Credential	:	LCSW ALSW MSW
Telephone Number	:	970-493-3833

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	08/22/2007

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Directions to “COUNSELING SERVICE ASSOCIATES ” Practice Location

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