Provider Demographics
NPI:1053888149
Name:LAURA MOGDEN COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:LAURA MOGDEN COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:970-903-2521
Mailing Address - Street 1:632 PEONY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1002
Mailing Address - Country:US
Mailing Address - Phone:970-903-2521
Mailing Address - Fax:
Practice Address - Street 1:546 MAIN ST STE 403
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2683
Practice Address - Country:US
Practice Address - Phone:970-596-8968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-27
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty