Healthcare Provider Details

I. General information

NPI: 1184486904
Provider Name (Legal Business Name): TWO TREES THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6860 S YOSEMITE CT # 2218
CENTENNIAL CO
80112-1409
US

IV. Provider business mailing address

6860 S YOSEMITE CT # 2218
CENTENNIAL CO
80112-1409
US

V. Phone/Fax

Practice location:
  • Phone: 630-292-4757
  • Fax:
Mailing address:
  • Phone: 207-500-2062
  • Fax: 303-796-0545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. FAYE KOUIMELIS
Title or Position: OWNER CLINICIAN
Credential: PSYD, OTR
Phone: 630-292-4757