Organization
BRILLIANTLY SANE COUNSELING AND COACHING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WALLACE LPC (OWNER)
(970) 368-9185
Entity
Organization
Contact information
Practice address
1600 BRADLEY CT, BOULDER, CO 80305-7310
(970) 368-9185
Mailing address
PO BOX 1211, SILVERTHORNE, CO 80498-1211
(970) 389-3612
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/19/2020
Last updated
06/13/2020
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