Provider Demographics
NPI:1306214523
Name:EAGLE COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:EAGLE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:COONS
Authorized Official - Suffix:
Authorized Official - Credentials:CACLLL
Authorized Official - Phone:303-623-4623
Mailing Address - Street 1:1337 DELAWARE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2701
Mailing Address - Country:US
Mailing Address - Phone:303-623-4623
Mailing Address - Fax:
Practice Address - Street 1:2200 CHAMBERS RD
Practice Address - Street 2:UNIT-E
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-3217
Practice Address - Country:US
Practice Address - Phone:303-623-4623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1523-03251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health