| Bristlecone Family Counseling Mental Health Therapy For Children | |
|
700 Valley View Dr Woodland Park CO 80863-8370 | |
| (719) 661-9323 | |
| (719) 434-9930 |
| Full Name | Bristlecone Family Counseling Mental Health Therapy For Children |
|---|---|
| Speciality | Counselor |
| Location | 700 Valley View Dr, Woodland Park, Colorado |
| Authorized Official Name and Position | Tamra Lee Bok (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7192837990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bristlecone Family Counseling Mental Health Therapy For Children 700 Valley View Dr Woodland Park CO 80863-8370 Ph: (719) 661-9323 | Bristlecone Family Counseling Mental Health Therapy For Children 700 Valley View Dr Woodland Park CO 80863-8370 Ph: (719) 661-9323 |
| NPI Number | 1134727308 |
|---|---|
| Provider Enumeration Date | 10/11/2020 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Medicare PECOS PAC ID | 9638500812 |
|---|---|
| Medicare Enrollment ID | O20250122002516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134727308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Tamra Lee Bok |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154653467 PECOS PAC ID: 4587095765 Enrollment ID: I20250122002625 |
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