| New Frontiers Counseling Llc | |
|
105 S Main St Fountain CO 80817-2215 | |
| (719) 217-4609 | |
| (719) 362-4281 |
| Full Name | New Frontiers Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 105 S Main St, Fountain, Colorado |
| Authorized Official Name and Position | Matthew C Banach (OWNER) |
| Authorized Official Contact | 7192174609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Frontiers Counseling Llc 105 S Main St Fountain CO 80817-2215 Ph: (719) 217-4609 | New Frontiers Counseling Llc 105 S Main St Fountain CO 80817-2215 Ph: (719) 217-4609 |
| NPI Number | 1194577098 |
|---|---|
| Provider Enumeration Date | 04/03/2024 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 7517308422 |
|---|---|
| Medicare Enrollment ID | O20240509001827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194577098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Matthew Banach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891255253 PECOS PAC ID: 0244566057 Enrollment ID: I20190731000975 |
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