Healthcare Provider Details

I. General information

NPI: 1225991169
Provider Name (Legal Business Name): REVERB STUDIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 E 7TH ST APT B
LOVELAND CO
80537-4956
US

IV. Provider business mailing address

1036 E 7TH ST APT B
LOVELAND CO
80537-4956
US

V. Phone/Fax

Practice location:
  • Phone: 970-232-1997
  • Fax:
Mailing address:
  • Phone: 970-232-1997
  • 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: KELSEY MEIGS
Title or Position: OWNER
Credential: MT-BC
Phone: 505-264-4535