Provider Demographics
NPI:1700646452
Name:UNCHARTED TRAVELER COUNSELING LLC
Entity Type:Organization
Organization Name:UNCHARTED TRAVELER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MICAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-306-1112
Mailing Address - Street 1:390 S POTOMAC WAY STE C
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2491
Mailing Address - Country:US
Mailing Address - Phone:720-306-1112
Mailing Address - Fax:
Practice Address - Street 1:390 S POTOMAC WAY STE C
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2491
Practice Address - Country:US
Practice Address - Phone:720-306-1112
Practice Address - Fax:720-783-2866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health