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DIGITAL MEDIA TREATMENT AND EDUCATION CENTER LLC NPI 1235791286


NPI Information

NPI: 1235791286
Provider Name: DIGITAL MEDIA TREATMENT AND EDUCATION CENTER, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
2299 PEARL ST STE 310
BOULDER, CO
ZIP 80302
Phone: (303) 635-6753
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DIGITAL MEDIA TREATMENT AND EDUCATION CENTER, LLC is a mental health counselor in Boulder, CO. DIGITAL MEDIA TREATMENT AND EDUCATION CENTER, LLC NPI is 1235791286. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2299 PEARL ST STE 310
BOULDER, CO
ZIP 80302-671
Phone: (303) 635-6753
Fax: (303) 593-1058

The provider's authorized official is Brett Kennedy .
The authorized official title is Owner, Co-director and has the following contact phone number (303) 632-8883.

The enumeration date for this NPI number is 6/30/2019 and was last updated on 6/30/2019.


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
1103T00000XPsychologistNo
2103TF0000XPsychologistFamilyNo
3101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11639234545MEDICAIDNEW YORK
21326345216MEDICAIDCOLORADO

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.