1912922683 NPI number — DENVER PSYCHOTHERAPY AND CONSULTATION SERVICES, LLC

Table of content: (NPI 1912922683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912922683 NPI number — DENVER PSYCHOTHERAPY AND CONSULTATION SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENVER PSYCHOTHERAPY AND CONSULTATION SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912922683
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 300265
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80203-0265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-399-9988
Provider Business Mailing Address Fax Number:
303-399-9977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
131 W 10TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-4013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-399-9988
Provider Business Practice Location Address Fax Number:
303-399-9977
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KENNEDY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
RYAN
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
303-399-9988

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  1570 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 163WP0808X , with the licence number: 116891 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





Copyright © 2007-2025 www.npivalidator.com