Provider Demographics
NPI:1700263290
Name:CHARISMATIC COUNSELING, PLLC
Entity type:Organization
Organization Name:CHARISMATIC COUNSELING, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC
Authorized Official - Phone:720-445-4337
Mailing Address - Street 1:7200 E DRY CREEK RD
Mailing Address - Street 2:SUITE C-202
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2537
Mailing Address - Country:US
Mailing Address - Phone:720-445-4337
Mailing Address - Fax:720-789-2995
Practice Address - Street 1:7200 E DRY CREEK RD
Practice Address - Street 2:SUITE C-202
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2537
Practice Address - Country:US
Practice Address - Phone:720-445-4337
Practice Address - Fax:720-789-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2016-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012014101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33376247Medicaid