Provider Demographics
NPI:1457392177
Name:COUNSELING & CONSULTATION SVCS, INC
Entity Type:Organization
Organization Name:COUNSELING & CONSULTATION SVCS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MUNNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-751-2710
Mailing Address - Street 1:2101 S BLACKHAWK ST
Mailing Address - Street 2:SUITE # 250
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1492
Mailing Address - Country:US
Mailing Address - Phone:303-751-2710
Mailing Address - Fax:
Practice Address - Street 1:2101 S BLACKHAWK ST
Practice Address - Street 2:SUITE # 250
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1492
Practice Address - Country:US
Practice Address - Phone:303-751-2710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9880161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO88766Medicare ID - Type Unspecified