Organization Active NPI

Forward Together/Adelante Juntos Counseling, LLC

  • Mental Health Counselor
  • Longmont, CO
National Provider Identifier
1417738550
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FORWARD TOGETHER/ADELANTE JUNTOS COUNSELING, LLC
Practice address
500 Coffman St Ste 204
Longmont, CO 80501-5445
Phone
(720) 204-8655
NPI assigned
Oct 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Cullom, LPC, LACNPI 1730678749
Title
Owner
Phone
(804) 370-9663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

500 Coffman St Ste 204
Longmont, CO 80501-5445

Mailing address

500 Coffman St Ste 204
Longmont, CO 80501-5445
Phone (720) 204-8655

National Provider Directory

National Provider Directory

Locations

2204 18th Ave
Ste 140
Longmont, CO 80501
Phone (720) 202-6009

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1417738550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COFFMAN ST STE 204",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805015445",
            "telephone_number": "720-204-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COFFMAN ST STE 204",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805015445",
            "telephone_number": "720-204-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORWARD TOGETHER/ADELANTE JUNTOS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "CULLOM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-370-9663",
        "authorized_official_credential": "LPC, LAC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.