1629536578 NPI number — ON SITE COUNSELING OF COLORADO, LLC.

Table of content: (NPI 1629536578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629536578 NPI number — ON SITE COUNSELING OF COLORADO, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ON SITE COUNSELING OF COLORADO, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629536578
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3007 CAROLINE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77004-2822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-942-8100
Provider Business Mailing Address Fax Number:
713-533-1408

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3007 CAROLINE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77004-2822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-942-8100
Provider Business Practice Location Address Fax Number:
713-533-1408
Provider Enumeration Date:
03/11/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARSAW
Authorized Official First Name:
TROY
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
713-942-8100

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)