1952573214 NPI number — MS. BERNADETTE ANN GIMPEL LMFT

Table of content: MS. BERNADETTE ANN GIMPEL LMFT (NPI 1952573214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952573214 NPI number — MS. BERNADETTE ANN GIMPEL LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIMPEL
Provider First Name:
BERNADETTE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BREEN
Provider Other First Name:
BERNADETTE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952573214
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 BROADWAY
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
BOULDER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-554-6710
Provider Business Mailing Address Fax Number:
303-554-1303

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
BOULDER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-554-6710
Provider Business Practice Location Address Fax Number:
303-554-1303
Provider Enumeration Date:
03/27/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  644 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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