| In The Moment Counseling, Llc | |
|
201 S Wilcox St Suite 202 Castle Rock CO 80104-3315 | |
| (720) 295-1199 | |
| (720) 634-0646 |
| Full Name | In The Moment Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 201 S Wilcox St, Castle Rock, Colorado |
| Authorized Official Name and Position | Kendra Liedtke (OWNER) |
| Authorized Official Contact | 7202951199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| In The Moment Counseling, Llc 201 S Wilcox St Suite 202 Castle Rock CO 80104-3315 Ph: (720) 295-1199 | In The Moment Counseling, Llc 201 S Wilcox St Suite 202 Castle Rock CO 80104-3315 Ph: (720) 295-1199 |
| NPI Number | 1417335035 |
|---|---|
| Provider Enumeration Date | 05/14/2015 |
| Last Update Date | 05/14/2015 |
| Medicare PECOS PAC ID | 0547580920 |
|---|---|
| Medicare Enrollment ID | O20150527000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417335035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 992871 (Colorado) | Primary |
| Provider Name | Kendra M Liedtke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295811891 PECOS PAC ID: 4981675592 Enrollment ID: I20040805000296 |
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