Provider Demographics
NPI:1326700907
Name:HUMANISTIC COUNSELING, LLC
Entity Type:Organization
Organization Name:HUMANISTIC COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TIERRAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-614-3177
Mailing Address - Street 1:4636 TALBOT DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2620
Mailing Address - Country:US
Mailing Address - Phone:313-614-3177
Mailing Address - Fax:
Practice Address - Street 1:1800 30TH ST STE 209D
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1087
Practice Address - Country:US
Practice Address - Phone:808-785-6321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty