Basic Information
| Provider Information | |||||||||
| NPI: | 1548869829 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MEADOWLARK COUNSELING AND ART THERAPY, PLLC | ||||||||
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| OtherOrganizationName: | DENVER COUNSELING AND ART THERAPY, PLLC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1106 S OAK ST | ||||||||
| Address2: | |||||||||
| City: | TRINIDAD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810823828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039216306 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1106 S OAK ST | ||||||||
| Address2: | |||||||||
| City: | TRINIDAD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810823828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039216306 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2020 | ||||||||
| LastUpdateDate: | 06/16/2021 | ||||||||
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| AuthorizedOfficialLastName: | MCGINTY | ||||||||
| AuthorizedOfficialFirstName: | ALISON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3039216306 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LPC | ||||||||
| NPICertificationDate: | 06/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.