Provider Demographics
NPI:1265152748
Name:SUMMIT TOGETHER MENTAL HEALTH, PLLC
Entity type:Organization
Organization Name:SUMMIT TOGETHER MENTAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE ADRIENNE
Authorized Official - Middle Name:CENANA
Authorized Official - Last Name:AGUILON
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:970-614-8842
Mailing Address - Street 1:#1075
Mailing Address - Street 2:1601 29TH ST. SUITE 1292
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:#1075
Practice Address - Street 2:1601 29TH ST. SUITE 1292
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:513-444-8995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty