Provider Demographics
NPI:1730840844
Name:FORTITUDE COUNSELING LLC
Entity type:Organization
Organization Name:FORTITUDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-772-9871
Mailing Address - Street 1:80 GARDEN CTR STE 40
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1777
Mailing Address - Country:US
Mailing Address - Phone:720-772-9871
Mailing Address - Fax:
Practice Address - Street 1:80 GARDEN CTR STE 40
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1777
Practice Address - Country:US
Practice Address - Phone:720-772-9871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty