Healthcare Provider Details

I. General information

NPI: 1477302156
Provider Name (Legal Business Name): TWO TREES THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 12/25/2024
Certification Date: 12/25/2024
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 STE 2218
CENTENNIAL CO
80112-1409
US

V. Phone/Fax

Practice location:
  • Phone: 720-500-2062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. FAYE N KOUIMELIS
Title or Position: CEO/PSYCHOLOGIST
Credential: PSYD
Phone: 720-500-6026