Provider Demographics
NPI:1982160776
Name:WHOLE CHILD COLORADO, LLC
Entity type:Organization
Organization Name:WHOLE CHILD COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOAK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:303-569-8109
Mailing Address - Street 1:PO BOX 7565
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-0565
Mailing Address - Country:US
Mailing Address - Phone:303-569-8109
Mailing Address - Fax:
Practice Address - Street 1:3401 QUEBEC ST STE 4500
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2310
Practice Address - Country:US
Practice Address - Phone:303-569-8109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty