| Majestic Counseling, Llc | |
|
121 N Park Ave Montrose CO 81401-3768 | |
| (928) 813-5500 | |
| (970) 986-4106 |
| Full Name | Majestic Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 121 N Park Ave, Montrose, Colorado |
| Authorized Official Name and Position | Alexis Baca-spry (OWNER) |
| Authorized Official Contact | 9288135500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Majestic Counseling, Llc Po Box 877 Montrose CO 81402-0877 Ph: (928) 813-5500 | Majestic Counseling, Llc 121 N Park Ave Montrose CO 81401-3768 Ph: (928) 813-5500 |
| NPI Number | 1255899357 |
|---|---|
| Provider Enumeration Date | 03/07/2019 |
| Last Update Date | 03/25/2020 |
| Certification Date | 03/25/2020 |
| Medicare PECOS PAC ID | 9133564644 |
|---|---|
| Medicare Enrollment ID | O20240223002632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255899357 | NPI | - | NPPES |
| 9000179119 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Alexis A Baca-spry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598194672 PECOS PAC ID: 1951746460 Enrollment ID: I20240307001261 |
| Provider Name | Denise Brennan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548961048 PECOS PAC ID: 3173997301 Enrollment ID: I20240429000045 |
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