Provider Demographics
NPI:1922393073
Name:COLORADO AUTISM CONSULTANTS, LLC
Entity type:Organization
Organization Name:COLORADO AUTISM CONSULTANTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/BEHAVIORAL CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOENIG
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:970-433-8339
Mailing Address - Street 1:PO BOX 4804
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-4804
Mailing Address - Country:US
Mailing Address - Phone:970-433-8339
Mailing Address - Fax:303-957-2251
Practice Address - Street 1:10650 E BETHANY DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2653
Practice Address - Country:US
Practice Address - Phone:800-536-2340
Practice Address - Fax:303-957-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0093572251S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000147145Medicaid