Provider Demographics
NPI:1982439840
Name:BALLANTINE COUNSELING
Entity type:Organization
Organization Name:BALLANTINE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALLANTINE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-515-5620
Mailing Address - Street 1:1620 DETROIT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1525
Mailing Address - Country:US
Mailing Address - Phone:303-868-5843
Mailing Address - Fax:
Practice Address - Street 1:1620 DETROIT ST APT 1
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1525
Practice Address - Country:US
Practice Address - Phone:303-868-5843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty