| Blue Channel Therapy | |
|
5460 Ward Rd Ste 150 Arvada CO 80002-1828 | |
| (720) 295-7548 | |
| Not Available |
| Full Name | Blue Channel Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 5460 Ward Rd Ste 150, Arvada, Colorado |
| Authorized Official Name and Position | Maia Longenecker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7202957548 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Channel Therapy 5460 Ward Rd Ste 150 Arvada CO 80002-1828 Ph: (720) 295-7548 | Blue Channel Therapy 5460 Ward Rd Ste 150 Arvada CO 80002-1828 Ph: (720) 295-7548 |
| NPI Number | 1811587199 |
|---|---|
| Provider Enumeration Date | 01/21/2021 |
| Last Update Date | 06/12/2023 |
| Certification Date | 06/12/2023 |
| Medicare PECOS PAC ID | 0941653364 |
|---|---|
| Medicare Enrollment ID | O20240201000494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811587199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
| Provider Name | Jennifer C Stancer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700014107 PECOS PAC ID: 8224269477 Enrollment ID: I20140401001256 |
| Provider Name | Allison I Rex |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396038428 PECOS PAC ID: 9537381207 Enrollment ID: I20141112002498 |
| Provider Name | Maia a Longenecker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497180129 PECOS PAC ID: 4981994795 Enrollment ID: I20160607002569 |
| Provider Name | Lynne Cole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205373065 PECOS PAC ID: 7618312869 Enrollment ID: I20240228001084 |
| Provider Name | Kathleen Marie Watson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942536040 PECOS PAC ID: 9032554183 Enrollment ID: I20240228001613 |
| Provider Name | Carleigh Bernard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720826571 PECOS PAC ID: 8820524432 Enrollment ID: I20241205003738 |
| Provider Name | Jessica Rubio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598574998 PECOS PAC ID: 3971033218 Enrollment ID: I20250216000036 |
| Provider Name | Aubrey Bertron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356226211 PECOS PAC ID: 6901309434 Enrollment ID: I20250911002422 |
| Provider Name | Vanessa Nicholls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396618609 PECOS PAC ID: 7517456411 Enrollment ID: I20251030002958 |
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