Organization
EXPERIENTIAL FAMILY THERAPY AND TRAINING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACIE KILLION MA, LMFT, LAC, RPT (OWNER/DIRECTOR)
(720) 757-1988
Entity
Organization
Contact information
Practice address
7175 W JEFFERSON AVE STE 1200, LAKEWOOD, CO 80235-2380
(720) 757-1988
(720) 306-5522
Mailing address
2974 W CHENANGO AVE, ENGLEWOOD, CO 80110-6308
(720) 757-1988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356798078
INDIVIDUAL NPI
—
01
—
ACA.0001175
LICENSED ADDICTION COUNSELOR
CO
01
—
MFT.0001840
MARRIAGE AND FAMILY THERAPIST
CO
Enumeration date
10/19/2020
Last updated
10/19/2020
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