| Vista Counseling, Pllc | |
|
5485 Conestoga Ct Boulder CO 80301 | |
| (720) 600-6035 | |
| Not Available |
| Full Name | Vista Counseling, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 5485 Conestoga Ct, Boulder, Colorado |
| Authorized Official Name and Position | Thomas J Devine (THERAPIST) |
| Authorized Official Contact | 7206006035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Counseling, Pllc Po Box 217 Arvada CO 80001-0217 Ph: (720) 600-6035 | Vista Counseling, Pllc 5485 Conestoga Ct Boulder CO 80301 Ph: (720) 600-6035 |
| NPI Number | 1053138784 |
|---|---|
| Provider Enumeration Date | 09/24/2024 |
| Last Update Date | 09/24/2024 |
| Certification Date | 09/24/2024 |
| Medicare PECOS PAC ID | 7113458779 |
|---|---|
| Medicare Enrollment ID | O20241007002006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053138784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Thomas James Devine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811270481 PECOS PAC ID: 7012448483 Enrollment ID: I20241009003270 |
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