Provider Demographics
NPI:1902131832
Name:FOOTHILLS COUNSELING CENTER PC
Entity Type:Organization
Organization Name:FOOTHILLS COUNSELING CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEAU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-989-2129
Mailing Address - Street 1:13701 W JEWELL AVE
Mailing Address - Street 2:SUITE 251
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4139
Mailing Address - Country:US
Mailing Address - Phone:303-989-2129
Mailing Address - Fax:303-989-1362
Practice Address - Street 1:13701 W JEWELL AVE
Practice Address - Street 2:SUITE 251
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4139
Practice Address - Country:US
Practice Address - Phone:303-989-2129
Practice Address - Fax:303-989-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC4183101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 103K00000X
FLBL74800B101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty