Provider Demographics
NPI:1306650387
Name:SURFACE CREEK COUNSELING LLC
Entity type:Organization
Organization Name:SURFACE CREEK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:APRIL
Authorized Official - Last Name:FRITCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-835-9223
Mailing Address - Street 1:13373 2600 RD
Mailing Address - Street 2:
Mailing Address - City:ECKERT
Mailing Address - State:CO
Mailing Address - Zip Code:81418-8500
Mailing Address - Country:US
Mailing Address - Phone:970-901-1590
Mailing Address - Fax:970-835-9230
Practice Address - Street 1:494 HIGHWAY 92 STE 300
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-3441
Practice Address - Country:US
Practice Address - Phone:970-835-9223
Practice Address - Fax:970-835-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-01
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty