Provider Demographics
NPI:1659783116
Name:YOUR STORY COUNSELING, LLC
Entity Type:Organization
Organization Name:YOUR STORY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC
Authorized Official - Phone:970-281-7879
Mailing Address - Street 1:1429 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-3010
Mailing Address - Country:US
Mailing Address - Phone:970-281-7879
Mailing Address - Fax:
Practice Address - Street 1:709 3RD AVE STE 201
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5926
Practice Address - Country:US
Practice Address - Phone:970-281-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0103841251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health