Provider Demographics
NPI:1346627072
Name:HEART OF LIFE COUNSELING LLC
Entity Type:Organization
Organization Name:HEART OF LIFE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ARIEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-226-6731
Mailing Address - Street 1:7995 E MISSISSIPPI AVE
Mailing Address - Street 2:J3
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2015
Mailing Address - Country:US
Mailing Address - Phone:720-226-6731
Mailing Address - Fax:303-322-1087
Practice Address - Street 1:3600 S BEELER ST STE 340
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1801
Practice Address - Country:US
Practice Address - Phone:720-226-6731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46024760Medicaid