| Staywell Counseling, Llc | |
|
402 Valley Rd Canon City CO 81212-4176 | |
| (719) 371-1078 | |
| Not Available |
| Full Name | Staywell Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 402 Valley Rd, Canon City, Colorado |
| Authorized Official Name and Position | Deborah Bradfield (OWNER) |
| Authorized Official Contact | 7193711078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Staywell Counseling, Llc 102 Yucca Ave Florence CO 81226-9548 Ph: (719) 371-0178 | Staywell Counseling, Llc 402 Valley Rd Canon City CO 81212-4176 Ph: (719) 371-1078 |
| NPI Number | 1750966701 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 03/11/2021 |
| Certification Date | 03/11/2021 |
| Medicare PECOS PAC ID | 8921417379 |
|---|---|
| Medicare Enrollment ID | O20210514001097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750966701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Deborah Bradfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477146967 PECOS PAC ID: 0749699197 Enrollment ID: I20210514001178 |
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