Organization
ASPENGLOW THERAPY COMPANY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH BRITTANI MASSEY BAIR LMFT, ADDC (THERAPIST)
(502) 295-0274
Entity
Organization
Contact information
Practice address
326 MAIN ST STE 200C, DELTA, CO 81416-1862
(502) 295-0274
Mailing address
860 TERRACE ST, DELTA, CO 81416-6702
(502) 295-0274
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629651401
NPI
—
05
—
9000197747
—
CO
Enumeration date
05/10/2024
Last updated
05/10/2024
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