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3570 E 12th Ave Ste 212 Denver CO 80206-3448 | |
| (720) 927-9007 | |
| (720) 664-4754 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 3570 E 12th Ave Ste 212, Denver, Colorado |
| Authorized Official Name and Position | Katherine Leigh Bates (CEO) |
| Authorized Official Contact | 6789087856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3570 E 12th Ave Ste 212 Denver CO 80206-3448 Ph: (720) 927-9007 | 3570 E 12th Ave Ste 212 Denver CO 80206-3448 Ph: (720) 927-9007 |
| NPI Number | 1396571246 |
|---|---|
| Provider Enumeration Date | 09/09/2024 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Medicare PECOS PAC ID | 6507398229 |
|---|---|
| Medicare Enrollment ID | O20241018000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396571246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 221700000X | Art Therapist | (* (Not Available)) | Secondary |
| Provider Name | Katherine Leigh Bates |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194288910 PECOS PAC ID: 7315479037 Enrollment ID: I20241018000454 |
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