Organization
REAL TALK COUNSELING FROM AN URBAN PERSPECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWAUNE LATIETH ELLIS M.S. (EXECUTIVE DIRECTOR)
(303) 377-0370
Entity
Organization
Contact information
Practice address
2323 S TROY ST STE 5-209, AURORA, CO 80014-1900
(303) 377-0370
Mailing address
2323 S TROY ST STE 5-209, AURORA, CO 80014-1900
(303) 377-0370
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2438-01
OBH COLORADO LICENSE
CO
Enumeration date
08/09/2022
Last updated
08/09/2022
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