Organization Name: | WAKING LIFE COUNSELING, LLC |
NPI Number: | 1114386885 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATIE-BETH WHITCOMB (COUNSELOR) |
Mailing Address: | 6363 W 120th Ave Suite 200 Broomfield |
State: | CO US |
Postal Code: | 800200300 |
Phone Number: | 3032532342 |
Fax Number: | |
NPI Enumeration Date: | 02/23/2016 |
NPI Last Update Date: | 02/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |