Provider Demographics
NPI:1558746479
Name:UNFOLDING POTENTIALS LLC
Entity Type:Organization
Organization Name:UNFOLDING POTENTIALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:636-368-1347
Mailing Address - Street 1:888 S DEXTER ST
Mailing Address - Street 2:#209
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2104
Mailing Address - Country:US
Mailing Address - Phone:720-515-9719
Mailing Address - Fax:
Practice Address - Street 1:13710 E RICE PL
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1074
Practice Address - Country:US
Practice Address - Phone:720-515-9719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health