Provider Demographics
NPI:1619498243
Name:RESTART COUNSELING
Entity Type:Organization
Organization Name:RESTART COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:ANTOINE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:720-585-4248
Mailing Address - Street 1:17011 LINCOLN AVE # 503
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3144
Mailing Address - Country:US
Mailing Address - Phone:720-585-4248
Mailing Address - Fax:
Practice Address - Street 1:17011 LINCOLN AVE # 503
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3144
Practice Address - Country:US
Practice Address - Phone:720-585-4248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC0107495253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CONLC0107495OtherREGISTERED PSYCHOTHERPIST