Provider Demographics
NPI:1720681927
Name:URBAN COLLECTIVE COUNSELING LLC
Entity Type:Organization
Organization Name:URBAN COLLECTIVE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-908-5050
Mailing Address - Street 1:PO BOX 40033
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-0033
Mailing Address - Country:US
Mailing Address - Phone:720-908-5050
Mailing Address - Fax:
Practice Address - Street 1:1229 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3905
Practice Address - Country:US
Practice Address - Phone:720-908-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty