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POUDRE VALLEY MEDICAL GROUP LLC NPI 1538775812


NPI Information

NPI: 1538775812
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC

Other Name: UCHEALTH REFRACTORY DEPRESSION CLINIC LONGS PEAK HOSPITAL

Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
1760 E KEN PRATT BLVD STE 305
LONGMONT, CO
ZIP 80504
Phone: (720) 718-8310
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POUDRE VALLEY MEDICAL GROUP, LLC is a psychiatry psychiatry neurology in Longmont, CO. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1538775812. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Uchealth Refractory Depression Clinic Longs Peak Hospital.

The provider's business location address is:

1760 E KEN PRATT BLVD STE 305
LONGMONT, CO
ZIP 80504-311
Phone: (720) 718-8310

The provider's authorized official is Jana Conroy .
The authorized official title is Director Of Credentialing and has the following contact phone number (970) 624-4443.

The enumeration date for this NPI number is 9/22/2020 and was last updated on 9/29/2023.


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
12084P0800XPsychiatry & NeurologyPsychiatryYes

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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