Healthcare Provider Details

I. General information

NPI: 1255253712
Provider Name (Legal Business Name): AMERICAN NEURODIVERGENT SUPPORT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

IV. Provider business mailing address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 317-938-3565
  • Fax:
Mailing address:
  • Phone: 317-938-3565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BONNIE FISHER
Title or Position: EXECUTIVE DIRECTOR
Credential: BC, MA
Phone: 317-938-3565