| Blue Channel Therapy | |
|
14901 E Hampden Ave Ste 120 Aurora CO 80014-5037 | |
| (720) 295-7548 | |
| Not Available |
| Full Name | Blue Channel Therapy |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 14901 E Hampden Ave Ste 120, Aurora, Colorado |
| Authorized Official Name and Position | Maia Longenecker (OWNER) |
| Authorized Official Contact | 7202957548 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Channel Therapy 5460 Ward Rd Ste 150 Arvada CO 80002-1828 Ph: (720) 295-7548 | Blue Channel Therapy 14901 E Hampden Ave Ste 120 Aurora CO 80014-5037 Ph: (720) 295-7548 |
| NPI Number | 1538890892 |
|---|---|
| Provider Enumeration Date | 06/18/2022 |
| Last Update Date | 06/12/2023 |
| Certification Date | 06/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538890892 | NPI | - | NPPES |
| 9000190521 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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