Organization
OUTDOOR COUNSELING COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK MICHAEL MINAGHAN LPC (OWNER)
(708) 805-9292
Entity
Organization
Contact information
Practice address
2855 BERGEN PEAK DR, EVERGREEN, CO 80439-2204
(708) 805-9292
Mailing address
1945 LA QUINTA LN, EVERGREEN, CO 80439-8958
(708) 805-9292
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770986408
—
CO
Enumeration date
10/31/2022
Last updated
10/31/2022
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