1508679895 NPI number — SUPPORTING AND EMPOWERING CONSULTING SERVICES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508679895 NPI number — SUPPORTING AND EMPOWERING CONSULTING SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUPPORTING AND EMPOWERING CONSULTING SERVICES PLLC
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:
6
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:
1508679895
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 N GRANT ST # 4785
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80203-1859
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-422-7218
Provider Business Mailing Address Fax Number:
970-236-4080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4701 STRAUSS CABIN RD APT 2209
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80528-4647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-422-7218
Provider Business Practice Location Address Fax Number:
970-236-4080
Provider Enumeration Date:
01/30/2025

Additional Information

Authorized Official

Authorized Official Last Name:
DESAI
Authorized Official First Name:
KUSH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
970-422-7218

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9000244156 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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