Provider Demographics
NPI:1053440529
Name:PASTORAL COUNSELING FOR DENVER, INC.
Entity Type:Organization
Organization Name:PASTORAL COUNSELING FOR DENVER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERREMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-741-5588
Mailing Address - Street 1:9185 E KENYON AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1822
Mailing Address - Country:US
Mailing Address - Phone:303-741-5588
Mailing Address - Fax:303-741-9977
Practice Address - Street 1:9185 E KENYON AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1822
Practice Address - Country:US
Practice Address - Phone:303-741-5588
Practice Address - Fax:303-741-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53052315Medicaid
CO345408Medicare ID - Type Unspecified