Organization
BLUE CHANNEL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAIA LONGENECKER LCSW (EXECUTIVE DIRECTOR)
(720) 295-7548
Entity
Organization
Contact information
Practice address
5460 WARD RD STE 150, ARVADA, CO 80002-1828
(720) 295-7548
Mailing address
5460 WARD RD STE 150, ARVADA, CO 80002-1828
(720) 295-7548
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/21/2021
Last updated
06/12/2023
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