Provider Demographics
NPI:1043925084
Name:IGNITE COUNSELING COLORADO
Entity Type:Organization
Organization Name:IGNITE COUNSELING COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AGOSTINO-VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-542-8338
Mailing Address - Street 1:8758 WOLFF CT STE 205
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1444 S POTOMAC ST STE 220
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4509
Practice Address - Country:US
Practice Address - Phone:303-578-6336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IGNITE COUNSELING COLORADO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty