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8000 E Prentice Ave Ste B2 Greenwood Village CO 80111-2726 | |
| (303) 474-4193 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 8000 E Prentice Ave Ste B2, Greenwood Village, Colorado |
| Authorized Official Name and Position | Jennifer Thorstad (OWNER) |
| Authorized Official Contact | 3039895534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1754 N Lafayette St Denver CO 80218-1117 Ph: () - | 8000 E Prentice Ave Ste B2 Greenwood Village CO 80111-2726 Ph: (303) 474-4193 |
| NPI Number | 1134864424 |
|---|---|
| Provider Enumeration Date | 05/01/2022 |
| Last Update Date | 12/02/2024 |
| Certification Date | 12/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134864424 | NPI | - | NPPES |
| 9000196598 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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