Provider Demographics
NPI:1952935751
Name:CONNECTIONS-ADOLESCENT AND FAMILY COUNSELING, LLC
Entity Type:Organization
Organization Name:CONNECTIONS-ADOLESCENT AND FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DUAL DIAGNOSIS PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CAC III
Authorized Official - Phone:970-315-2595
Mailing Address - Street 1:2015 KENTMERE DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-2324
Mailing Address - Country:US
Mailing Address - Phone:303-521-7820
Mailing Address - Fax:
Practice Address - Street 1:500 9TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4545
Practice Address - Country:US
Practice Address - Phone:970-315-2595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty