Healthcare Provider Details

I. General information

NPI: 1346488111
Provider Name (Legal Business Name): THE THERAPY CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2009
Last Update Date: 10/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9233 PARK MEADOWS DRIVE SUITE 212
LONE TREE CO
80124-5426
US

IV. Provider business mailing address

5200 S ULSTER ST APT 1613
GREENWOOD VILLAGE CO
80111
US

V. Phone/Fax

Practice location:
  • Phone: 303-792-3414
  • Fax:
Mailing address:
  • Phone: 303-792-3414
  • Fax: 303-261-8283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number907
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number907
License Number StateCO

VIII. Authorized Official

Name: DR. CARYN GOLDBERG
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 303-792-3414