Provider Demographics
NPI:1811523608
Name:ALPINE LAKES COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:ALPINE LAKES COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHELSIE
Authorized Official - Middle Name:DANETTE
Authorized Official - Last Name:HOPPERSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-219-9548
Mailing Address - Street 1:1707 CEYLON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5237
Mailing Address - Country:US
Mailing Address - Phone:720-299-1221
Mailing Address - Fax:
Practice Address - Street 1:14201 E 4TH AVE STE 3-265
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8748
Practice Address - Country:US
Practice Address - Phone:303-219-9548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPINE LAKES COUNSELING CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1386012706Medicaid