Provider Demographics
NPI:1841815677
Name:JUNIPER WEST COUNSELING, INC.
Entity type:Organization
Organization Name:JUNIPER WEST COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-783-0340
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:COLLBRAN
Mailing Address - State:CO
Mailing Address - Zip Code:81624-0193
Mailing Address - Country:US
Mailing Address - Phone:970-783-0340
Mailing Address - Fax:
Practice Address - Street 1:58128 HIGHWAY 330 UNIT 6
Practice Address - Street 2:
Practice Address - City:COLLBRAN
Practice Address - State:CO
Practice Address - Zip Code:81624-9502
Practice Address - Country:US
Practice Address - Phone:970-783-0340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty