|
| |
|
109 N Rutherford Ave Johnstown CO 80534-8639 | |
| (970) 619-1920 | |
| (970) 449-7519 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 109 N Rutherford Ave, Johnstown, Colorado |
| Authorized Official Name and Position | Brooke Johnson (OFFICE MANAGER) |
| Authorized Official Contact | 9705341967 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
138 E 4th St Ste 8 Loveland CO 80537-5502 Ph: (970) 619-1920 | 109 N Rutherford Ave Johnstown CO 80534-8639 Ph: (970) 619-1920 |
| NPI Number | 1073165296 |
|---|---|
| Provider Enumeration Date | 07/09/2019 |
| Last Update Date | 06/23/2021 |
| Certification Date | 05/28/2021 |
| Medicare PECOS PAC ID | 4486195906 |
|---|---|
| Medicare Enrollment ID | O20240924001049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073165296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Nicole Tolle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861696692 PECOS PAC ID: 8820539349 Enrollment ID: I20240926000921 |
Illuminated Path Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 W South 1st St, Johnstown, CO 80534 Phone: 970-231-2681 | |
Anchored By Grace Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4435 Ronald Reagan Blvd, Johnstown, CO 80534 Phone: 970-310-7706 | |
Wateringseed Recovery Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 262 Goldfinch Ln, Johnstown, CO 80534 Phone: 970-988-1856 | |
Starting With You Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3379 Shadbush St, Johnstown, CO 80534 Phone: 970-587-3699 | |
Jeremy T. Sharp, Ph.d., Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4435 Ronald Reagan Blvd, Johnstown, CO 80534 Phone: 970-889-8204 Fax: 888-494-3756 |