MEDICARE: FLOWING RIVER THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1134060866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOWING RIVER THERAPY LLC

Provider Business Mailing Address
First Line	:	1901 E 13TH AVE APT 5A
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-2065
Country	:	US
Telephone Number	:	303-351-1190
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 E 13TH AVE APT 5A
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-2065
Country	:	US
Telephone Number	:	303-351-1190
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENJAMIN LEE LIST
Credential	:	LCSW
Telephone Number	:	303-351-1190

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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