Provider Demographics
NPI:1508612433
Name:BE OF GOOD CHEER SERVICES
Entity type:Organization
Organization Name:BE OF GOOD CHEER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ASCHENBRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-470-5260
Mailing Address - Street 1:10071 E 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-5775
Mailing Address - Country:US
Mailing Address - Phone:720-470-5260
Mailing Address - Fax:
Practice Address - Street 1:36 S 18TH AVE STE D3
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2452
Practice Address - Country:US
Practice Address - Phone:720-470-5260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000228482Medicaid
CO1235330085OtherNPI