Provider Demographics
NPI:1902318827
Name:ALPINE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:ALPINE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:070-286-4886
Mailing Address - Street 1:PO BOX 2973
Mailing Address - Street 2:
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-2973
Mailing Address - Country:US
Mailing Address - Phone:970-286-4886
Mailing Address - Fax:866-291-0519
Practice Address - Street 1:363 EAST ELKHORN AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-8905
Practice Address - Country:US
Practice Address - Phone:970-286-4886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCW-000019591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COSUSANMSW88OtherOPTUM
CO80182364Medicaid