| Radiant Pathways Counseling & Wellness | |
|
1942 Broadway Ste 314c Boulder CO 80302-5233 | |
| (319) 855-7899 | |
| (303) 496-0786 |
| Full Name | Radiant Pathways Counseling & Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 1942 Broadway Ste 314c, Boulder, Colorado |
| Authorized Official Name and Position | Jacob Andrew Sandoval (OWNER, CEO) |
| Authorized Official Contact | 3198557899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Pathways Counseling & Wellness 6732 W Coal Mine Ave Ste 139 Littleton CO 80123-4573 Ph: (319) 855-7899 | Radiant Pathways Counseling & Wellness 1942 Broadway Ste 314c Boulder CO 80302-5233 Ph: (319) 855-7899 |
| NPI Number | 1871273375 |
|---|---|
| Provider Enumeration Date | 07/19/2023 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Medicare PECOS PAC ID | 1658712724 |
|---|---|
| Medicare Enrollment ID | O20240508000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871273375 | NPI | - | NPPES |
| Provider Name | Jacob Andrew Sandoval |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1255959391 PECOS PAC ID: 2567803638 Enrollment ID: I20240508000214 |
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