Provider Demographics
NPI:1134496359
Name:A NEW OUTLOOK COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:A NEW OUTLOOK COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-837-0491
Mailing Address - Street 1:1745 SHEA CENTER DR
Mailing Address - Street 2:#421
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129
Mailing Address - Country:US
Mailing Address - Phone:720-344-4885
Mailing Address - Fax:720-344-4804
Practice Address - Street 1:1745 SHEA CENTER DR.
Practice Address - Street 2:#421
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129
Practice Address - Country:US
Practice Address - Phone:720-344-4885
Practice Address - Fax:720-344-4804
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A NEW OUTLOOK COUNSELING SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-17
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO236302F00000X, 302R00000X, 305R00000X, 305S00000X
COACD236305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05735017Medicaid