| Supported Change,llc | |
|
609 W Littleton Blvd Suite 201 Littleton CO 80120 | |
| (720) 507-5023 | |
| Not Available |
| Full Name | Supported Change,llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 609 W Littleton Blvd Suite 201, Littleton, Colorado |
| Authorized Official Name and Position | Allison Johanson (OWNER/LCSW) |
| Authorized Official Contact | 7205075023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supported Change,llc Po Box 3414 Littleton CO 80120 Ph: () - | Supported Change,llc 609 W Littleton Blvd Suite 201 Littleton CO 80120 Ph: (720) 507-5023 |
| NPI Number | 1760837132 |
|---|---|
| Provider Enumeration Date | 05/04/2016 |
| Last Update Date | 08/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760837132 | NPI | - | NPPES |
| 11070382 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2112 (Colorado) | Primary |
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