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NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC NPI 1659794477


NPI Information

NPI: 1659794477
Provider Name: NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
4115 BOARDWALK DRIVE, SUITE 100
FORT COLLINS, CO
ZIP 80525
Phone: (970) 493-4580
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NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC is a clinical social worker in Fort Collins, CO. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC NPI is 1659794477. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4115 BOARDWALK DRIVE, SUITE 100
FORT COLLINS, CO
ZIP 80525-945
Phone: (970) 493-4580
Fax: (970) 797-2859

The provider's authorized official is Lisa Pendleton .
The authorized official title is Clinical Director and has the following contact phone number (970) 493-4580.

The enumeration date for this NPI number is 1/30/2014 and was last updated on 9/8/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1106H00000XMarriage & Family Therapist974COLORADONo
2106H00000XMarriage & Family Therapist983COLORADONo
3101YP2500XCounselorProfessional12332COLORADONo
41041C0700XSocial WorkerClinical9923938COLORADOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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