Provider Demographics
NPI:1992248843
Name:EQUINOX COUNSELING LLC
Entity type:Organization
Organization Name:EQUINOX COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:BENEDICT
Authorized Official - Last Name:PETRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-569-4588
Mailing Address - Street 1:9331 S COLORADO BLVD
Mailing Address - Street 2:SUITE 60
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7467
Mailing Address - Country:US
Mailing Address - Phone:303-569-4588
Mailing Address - Fax:303-569-4585
Practice Address - Street 1:9331 S COLORADO BLVD
Practice Address - Street 2:SUITE 60
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7467
Practice Address - Country:US
Practice Address - Phone:303-569-4588
Practice Address - Fax:303-569-4585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-27
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012121251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health