Healthcare Provider Details
I. General information
NPI: 1508721713
Provider Name (Legal Business Name): PASSAGES FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 S AIRPORT RD STE G
LONGMONT CO
80503-6424
US
IV. Provider business mailing address
PO BOX 1534
SPRING VALLEY CA
91979-1534
US
V. Phone/Fax
- Phone: 303-630-9433
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAMARA
GRAFF
Title or Position: PRESIDENT
Credential: LMFT
Phone: 619-784-1032