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General NPI Number Information
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NPI Number | 1265053961
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Entity Type | Organization
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Legal Business Name | POSITIVE REGARD PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 5818 ORCHARD CREEK LN
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City | BOULDER
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State | CO
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Zip | 80301-5823
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Country | US
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Telephone | 720-730-8621
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Fax | 720-815-0235
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Provider Business Mailing Address
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Address Line | 5818 ORCHARD CREEK LN
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City | BOULDER
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State | CO
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Zip | 80301-5823
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Country | US
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Telephone | 720-730-8621
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Fax | 720-815-0235
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DAVID E ANDERSON
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Credential | LPC
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Telephone | 720-730-8621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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