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1754 N Lafayette St Denver CO 80218-1117 | |
| (303) 474-4193 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1754 N Lafayette St, Denver, Colorado |
| Authorized Official Name and Position | Jennifer Thorstad (OWNER) |
| Authorized Official Contact | 3039895534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1754 N Lafayette St Denver CO 80218-1117 Ph: (303) 474-4193 | 1754 N Lafayette St Denver CO 80218-1117 Ph: (303) 474-4193 |
| NPI Number | 1053086868 |
|---|---|
| Provider Enumeration Date | 08/12/2021 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Medicare PECOS PAC ID | 0941649917 |
|---|---|
| Medicare Enrollment ID | O20240424000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053086868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Christina Glewen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598265670 PECOS PAC ID: 6002244100 Enrollment ID: I20220510001204 |
| Provider Name | Jennifer Thorstad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528362209 PECOS PAC ID: 4486093457 Enrollment ID: I20240424000711 |
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