Provider Demographics
NPI:1821741745
Name:COUNSELING ASPEN PLLC
Entity Type:Organization
Organization Name:COUNSELING ASPEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:MAX
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NLC0105480
Authorized Official - Phone:970-309-4732
Mailing Address - Street 1:80 RIVERDOWN DR
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1068
Mailing Address - Country:US
Mailing Address - Phone:970-309-4732
Mailing Address - Fax:
Practice Address - Street 1:1280 S UTE AVE STE 16
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2259
Practice Address - Country:US
Practice Address - Phone:970-309-4732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)