Provider Demographics
NPI:1801512140
Name:POLARIS PARTNERS COUNSELING AND CONSULTING LLC
Entity type:Organization
Organization Name:POLARIS PARTNERS COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:970-576-1717
Mailing Address - Street 1:155 S MADISON ST STE 306
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3014
Mailing Address - Country:US
Mailing Address - Phone:970-576-1717
Mailing Address - Fax:208-567-5844
Practice Address - Street 1:411 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-2141
Practice Address - Country:US
Practice Address - Phone:866-285-2929
Practice Address - Fax:208-567-5844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty