| Comanche Crossing Counseling, Llc | |
|
190 S 1st St Bennett CO 80102-7860 | |
| (303) 644-4240 | |
| (303) 644-4250 |
| Full Name | Comanche Crossing Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 190 S 1st St, Bennett, Colorado |
| Authorized Official Name and Position | Marla M Madrid (OWNER) |
| Authorized Official Contact | 3036444240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comanche Crossing Counseling, Llc 190 S 1st St Bennett CO 80102-7860 Ph: (303) 644-4240 | Comanche Crossing Counseling, Llc 190 S 1st St Bennett CO 80102-7860 Ph: (303) 644-4240 |
| NPI Number | 1710374640 |
|---|---|
| Provider Enumeration Date | 04/17/2015 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Medicare PECOS PAC ID | 8820392137 |
|---|---|
| Medicare Enrollment ID | O20160208000487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710374640 | NPI | - | NPPES |
| 1992046908 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CSW00001915 (Colorado) | Primary |
| Provider Name | Marla Madrid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992046908 PECOS PAC ID: 5193034536 Enrollment ID: I20160208001108 |
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