1346764891 NPI number — UTOPIA COUNSELING SERVICES

Table of content: (NPI 1346764891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346764891 NPI number — UTOPIA COUNSELING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UTOPIA COUNSELING SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346764891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1350 BEVERLY RD STE 115
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC LEAN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22101-3917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-506-6132
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6400 S FIDDLERS GREEN CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENWOOD VILLAGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80111-4950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-506-6132
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROUMAIN-OCHOA
Authorized Official First Name:
RHESIA-MARIA
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PRESIDENT/PSYCHOTHERAPIST
Authorized Official Telephone Number:
303-506-6132

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1916 . This is a "PROFESSIONAL LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".