Provider Demographics
NPI:1376064923
Name:BRYAN COUNSELING INC.
Entity Type:Organization
Organization Name:BRYAN COUNSELING INC.
Other - Org Name:BRYAN COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONAH
Authorized Official - Middle Name:ISAAC
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:970-290-0336
Mailing Address - Street 1:2424 COVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1282
Mailing Address - Country:US
Mailing Address - Phone:970-290-0336
Mailing Address - Fax:
Practice Address - Street 1:323 W DRAKE RD STE 216
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-8120
Practice Address - Country:US
Practice Address - Phone:970-290-0336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty