| Olive Branch Counseling | |
|
430 Beacon Lite Rd Unit 125 Monument CO 80132-9182 | |
| (719) 425-8814 | |
| (719) 212-1126 |
| Full Name | Olive Branch Counseling |
|---|---|
| Speciality | Counselor |
| Location | 430 Beacon Lite Rd Unit 125, Monument, Colorado |
| Authorized Official Name and Position | Melissa Coleen Powell (OWNER) |
| Authorized Official Contact | 7194258814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Branch Counseling 17886 Mining Way Monument CO 80132-8175 Ph: (719) 425-8814 | Olive Branch Counseling 430 Beacon Lite Rd Unit 125 Monument CO 80132-9182 Ph: (719) 425-8814 |
| NPI Number | 1053166025 |
|---|---|
| Provider Enumeration Date | 04/22/2024 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Medicare PECOS PAC ID | 3870933138 |
|---|---|
| Medicare Enrollment ID | O20240503000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053166025 | NPI | - | NPPES |
| 9000170087 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Melissa Coleen Powell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457817702 PECOS PAC ID: 4789024043 Enrollment ID: I20240503000325 |
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