Provider Demographics
NPI:1487226072
Name:REDWOOD HEART COUNSELING, LLC
Entity Type:Organization
Organization Name:REDWOOD HEART COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-430-6751
Mailing Address - Street 1:832 W EISENHOWER BLVD STE B5
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3134
Mailing Address - Country:US
Mailing Address - Phone:970-430-6751
Mailing Address - Fax:
Practice Address - Street 1:832 W EISENHOWER BLVD STE B3
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3134
Practice Address - Country:US
Practice Address - Phone:970-412-9256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty