| Rustic River Counseling Services Pllc | |
|
3307 S College Ave Unit 216a Fort Collins CO 80525-4196 | |
| (970) 294-3088 | |
| (970) 294-3228 |
| Full Name | Rustic River Counseling Services Pllc |
|---|---|
| Speciality | Counselor |
| Location | 3307 S College Ave Unit 216a, Fort Collins, Colorado |
| Authorized Official Name and Position | Jordan Elizabeth Jowder (OWNER/LPC) |
| Authorized Official Contact | 3037755545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rustic River Counseling Services Pllc 3307 S College Ave Unit 216a Fort Collins CO 80525-4196 Ph: (970) 294-3088 | Rustic River Counseling Services Pllc 3307 S College Ave Unit 216a Fort Collins CO 80525-4196 Ph: (970) 294-3088 |
| NPI Number | 1558054700 |
|---|---|
| Provider Enumeration Date | 06/01/2023 |
| Last Update Date | 06/01/2023 |
| Certification Date | 06/01/2023 |
| Medicare PECOS PAC ID | 2264875103 |
|---|---|
| Medicare Enrollment ID | O20240208000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558054700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jordan Elizabeth Jowder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255077871 PECOS PAC ID: 3173966017 Enrollment ID: I20240208000902 |
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