| Life Counseling And Consulting, Pllc | |
|
831 Royal Gorge Blvd Suite 217 Canon City CO 81212-6709 | |
| (719) 722-2722 | |
| (719) 452-3752 |
| Full Name | Life Counseling And Consulting, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 831 Royal Gorge Blvd, Canon City, Colorado |
| Authorized Official Name and Position | Life Counseling And Consulting Pllc (MANAGER) |
| Authorized Official Contact | 6059416660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Counseling And Consulting, Pllc 831 Royal Gorge Blvd Suite 217 Canon City CO 81212-6709 Ph: (719) 722-2722 | Life Counseling And Consulting, Pllc 831 Royal Gorge Blvd Suite 217 Canon City CO 81212-6709 Ph: (719) 722-2722 |
| NPI Number | 1518400837 |
|---|---|
| Provider Enumeration Date | 11/18/2016 |
| Last Update Date | 04/23/2017 |
| Medicare PECOS PAC ID | 0042592123 |
|---|---|
| Medicare Enrollment ID | O20170125001732 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518400837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ACD40000646 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW09923604 (Colorado) | Primary |
| Provider Name | Kristi Lynn Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275718215 PECOS PAC ID: 8527249390 Enrollment ID: I20141231000513 |
| Provider Name | Charmayne Noel Sandoval |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215221320 PECOS PAC ID: 8527373760 Enrollment ID: I20150817001419 |
| Provider Name | Brooke J Beckham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811333172 PECOS PAC ID: 3779726807 Enrollment ID: I20170125001822 |
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