Organization
MOUNTAINSIDE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MOULTON MA, LPC, NCC (OWNER)
(303) 819-4774
Entity
Organization
Contact information
Practice address
1023 39TH AVE STE B, GREELEY, CO 80634-2502
(970) 408-0404
Mailing address
1023 39TH AVE STE B, GREELEY, CO 80634-2502
(970) 408-0404
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700303286
LPC
CO
Enumeration date
11/26/2018
Last updated
09/27/2022
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