Provider Demographics
NPI:1548599574
Name:EQUINOX COUNSELING AND WELLNESS CENTER
Entity Type:Organization
Organization Name:EQUINOX COUNSELING AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:303-861-1916
Mailing Address - Street 1:1115 GRANT ST
Mailing Address - Street 2:G-6
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2369
Mailing Address - Country:US
Mailing Address - Phone:303-861-1916
Mailing Address - Fax:303-458-1941
Practice Address - Street 1:1115 GRANT ST
Practice Address - Street 2:G-6
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2369
Practice Address - Country:US
Practice Address - Phone:303-861-1916
Practice Address - Fax:303-458-1941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3967251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health