| Other Road Counseling Center Pllc | |
|
2004 W 15th St Ste 2 Loveland CO 80538-3551 | |
| (970) 217-2486 | |
| (855) 217-8024 |
| Full Name | Other Road Counseling Center Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2004 W 15th St Ste 2, Loveland, Colorado |
| Authorized Official Name and Position | Mallorie Smolen (LCSW) |
| Authorized Official Contact | 8602145492 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Other Road Counseling Center Pllc 2004 W 15th St Ste 2 Loveland CO 80538-3551 Ph: () - | Other Road Counseling Center Pllc 2004 W 15th St Ste 2 Loveland CO 80538-3551 Ph: (970) 217-2486 |
| NPI Number | 1316407802 |
|---|---|
| Provider Enumeration Date | 03/21/2019 |
| Last Update Date | 03/20/2024 |
| Certification Date | 03/20/2024 |
| Medicare PECOS PAC ID | 1254752256 |
|---|---|
| Medicare Enrollment ID | O20200824000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316407802 | NPI | - | NPPES |
| 09925655 | Other | CO | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mallorie D Smolen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346597887 PECOS PAC ID: 9739407180 Enrollment ID: I20200824000632 |
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