Healthcare Provider Details

I. General information

NPI: 1881216091
Provider Name (Legal Business Name): ARRAY CLINICAL AND THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 21ST AVE STE B
LONGMONT CO
80501-1483
US

IV. Provider business mailing address

451 21ST AVE STE B
LONGMONT CO
80501-1483
US

V. Phone/Fax

Practice location:
  • Phone: 800-440-1652
  • Fax: 970-775-8107
Mailing address:
  • Phone: 800-440-1652
  • Fax: 303-545-5296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER KELLY ORDWAY
Title or Position: CHIEF DEVELOPMENT OFFICER
Credential:
Phone: 303-824-9350