| Source Counseling | |
|
177 Sherman Street #101 Balance Natural Medicine Ridgway CO 81432 | |
| (970) 729-0862 | |
| Not Available |
| Full Name | Source Counseling |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 177 Sherman Street #101, Ridgway, Colorado |
| Authorized Official Name and Position | Lynton Moore (COUNSELPR) |
| Authorized Official Contact | 9707290862 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Source Counseling Po Box 685 Ridgway CO 81432-0685 Ph: (970) 729-0862 | Source Counseling 177 Sherman Street #101 Balance Natural Medicine Ridgway CO 81432 Ph: (970) 729-0862 |
| NPI Number | 1427456490 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 01/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427456490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC0011756 (Colorado) | Primary |
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