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2460 W 26th Ave Ste 165c Denver CO 80211-5307 | |
| (720) 306-1383 | |
| (719) 309-0911 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2460 W 26th Ave Ste 165c, Denver, Colorado |
| Authorized Official Name and Position | Marsha Evans (OWNER) |
| Authorized Official Contact | 3032649448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2460 W 26th Ave Ste 30c Denver CO 80211-5340 Ph: (720) 306-1383 | 2460 W 26th Ave Ste 165c Denver CO 80211-5307 Ph: (720) 306-1383 |
| NPI Number | 1235682220 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 06/27/2024 |
| Certification Date | 06/27/2024 |
| Medicare PECOS PAC ID | 0648619114 |
|---|---|
| Medicare Enrollment ID | O20240627001318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235682220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | 12139 (Colorado) | Primary |
| Provider Name | Marsha Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902200637 PECOS PAC ID: 5496068538 Enrollment ID: I20240627004296 |
| Provider Name | Crystal Netuschil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174196372 PECOS PAC ID: 3274073598 Enrollment ID: I20240912002088 |
| Provider Name | Cassandra Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639654973 PECOS PAC ID: 6103367479 Enrollment ID: I20240926002004 |
| Provider Name | Adam Joseph Miller Wojteczko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871058909 PECOS PAC ID: 8921532847 Enrollment ID: I20241114000345 |
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