Philip Vidal
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Thornton, CO
NPI 1124363429 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1124363429
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 6248 (CO)
- Practice address
- 8931 Huron St
Thornton, CO 80260-6806 - Phone
- (303) 853-3500
- NPI assigned
- Nov 28, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6248 | CO | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6248 | CO | Yes |
Addresses
Primary practice location
8931 Huron St
Thornton, CO 80260-6806
Mailing address
8931 Huron St
Thornton, CO 80260-6806
Phone (303) 853-3500
Other providers in Thornton, CO
- Vernon Y.J. Lee DO P.C.
- Veros Clinical Services LLC
- Vibra Hospital of Denver LLC
- Vibra Hospital of Denver LLC
- Vida Plena Wellness
- Carol Vidaurre
- Desirae Renee Vigil
- Shirley Ann Vigil
- Anjana Vijayakumar
- Mechelle D. Viola-Lewis
All providers in Thornton, CO · Addiction (Substance Use Disorder) Counselor in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.