Provider Demographics
NPI:1124771274
Name:TWO OWLS COUNSELING LLC
Entity type:Organization
Organization Name:TWO OWLS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER, LLC
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COYOTE
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LPC,NCC
Authorized Official - Phone:970-402-3135
Mailing Address - Street 1:PO BOX 21150
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308-4150
Mailing Address - Country:US
Mailing Address - Phone:970-402-3135
Mailing Address - Fax:
Practice Address - Street 1:2625 REDWING RD STE 175
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6324
Practice Address - Country:US
Practice Address - Phone:970-402-3135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TWO OWLS COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-29
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty