| Bright Life Counseling | |
|
1011 Mercury Dr Lafayette CO 80026-2771 | |
| (720) 263-0047 | |
| (720) 306-5232 |
| Full Name | Bright Life Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 1011 Mercury Dr, Lafayette, Colorado |
| Authorized Official Name and Position | Samantha Campanelli (OWNER) |
| Authorized Official Contact | 7202630047 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Life Counseling 1011 Mercury Dr Lafayette CO 80026-2771 Ph: (720) 490-6730 | Bright Life Counseling 1011 Mercury Dr Lafayette CO 80026-2771 Ph: (720) 263-0047 |
| NPI Number | 1053874990 |
|---|---|
| Provider Enumeration Date | 04/08/2019 |
| Last Update Date | 02/24/2020 |
| Certification Date | 02/24/2020 |
| Medicare PECOS PAC ID | 1456694983 |
|---|---|
| Medicare Enrollment ID | O20190523001630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053874990 | NPI | - | NPPES |
| 9000172052 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Samantha Campanelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184902777 PECOS PAC ID: 2365785896 Enrollment ID: I20190523001690 |
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