Provider Demographics
NPI:1518748532
Name:WISE COUNSELING
Entity Type:Organization
Organization Name:WISE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PARKER
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LSW
Authorized Official - Phone:443-480-0600
Mailing Address - Street 1:270 E FLATIRON CROSSING DR UNIT 1173
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8118
Mailing Address - Country:US
Mailing Address - Phone:720-912-2044
Mailing Address - Fax:
Practice Address - Street 1:4790 TABLE MESA DR STE 108
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5660
Practice Address - Country:US
Practice Address - Phone:720-263-0334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health