| Supportive Connection Counseling, P.l.l.c. | |
|
2126 Cutting Horse Dr Fort Collins CO 80525-2198 | |
| (970) 219-8674 | |
| Not Available |
| Full Name | Supportive Connection Counseling, P.l.l.c. |
|---|---|
| Speciality | Counselor |
| Location | 2126 Cutting Horse Dr, Fort Collins, Colorado |
| Authorized Official Name and Position | Beth Hasbrouck (OWNER) |
| Authorized Official Contact | 9702198674 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Connection Counseling, P.l.l.c. 2126 Cutting Horse Dr Fort Collins CO 80525-2198 Ph: (970) 219-8674 | Supportive Connection Counseling, P.l.l.c. 2126 Cutting Horse Dr Fort Collins CO 80525-2198 Ph: (970) 219-8674 |
| NPI Number | 1487478145 |
|---|---|
| Provider Enumeration Date | 11/11/2024 |
| Last Update Date | 11/11/2024 |
| Certification Date | 11/10/2024 |
| Medicare PECOS PAC ID | 7911432216 |
|---|---|
| Medicare Enrollment ID | O20241122003755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487478145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Beth Hasbrouck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013589084 PECOS PAC ID: 8820523129 Enrollment ID: I20241212000643 |
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