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EXTREME SPORTS CAMP NPI 1669744637


NPI Information

NPI: 1669744637
Provider Name: EXTREME SPORTS CAMP
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
23286 TWO RIVERS RD
SUITE 24-A
BASALT, CO
ZIP 81621
Phone: (970) 927-3143
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EXTREME SPORTS CAMP is a counselor in Basalt, CO. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. EXTREME SPORTS CAMP NPI is 1669744637. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

23286 TWO RIVERS RD
SUITE 24-A
BASALT, CO
ZIP 81621-285
Phone: (970) 927-3143

The provider's authorized official is Sallie Bernard .
The authorized official title is Executive Director and has the following contact phone number (970) 927-0433.

The enumeration date for this NPI number is 2/6/2012 and was last updated on 2/6/2012.


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
1101Y00000XCounselor1534517COLORADOYes

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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