Provider Demographics
NPI:1508679895
Name:SUPPORTING AND EMPOWERING CONSULTING SERVICES PLLC
Entity type:Organization
Organization Name:SUPPORTING AND EMPOWERING CONSULTING SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-422-7218
Mailing Address - Street 1:4529 STOVER ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3261
Mailing Address - Country:US
Mailing Address - Phone:970-422-7218
Mailing Address - Fax:970-236-4080
Practice Address - Street 1:4529 STOVER ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3261
Practice Address - Country:US
Practice Address - Phone:970-422-7218
Practice Address - Fax:970-236-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000244156Medicaid