Provider Demographics
NPI:1689912388
Name:DURANGO COUNSELING AND TOUCH THERAPIES
Entity Type:Organization
Organization Name:DURANGO COUNSELING AND TOUCH THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.A.
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-903-0465
Mailing Address - Street 1:128 W 14TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5100
Mailing Address - Country:US
Mailing Address - Phone:970-903-0465
Mailing Address - Fax:
Practice Address - Street 1:128 W 14TH ST STE 206
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5100
Practice Address - Country:US
Practice Address - Phone:970-903-0465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8507101YP2500X
CO176205163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1447295068OtherNPI
COS46736Medicare UPIN