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General NPI Number Information
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NPI Number | 1417681222
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Entity Type | Organization
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Legal Business Name | BLUE CHANNEL THERAPY
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Dates
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Enumeration Date | 07/16/2022
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 10465 MELODY DR STE 322
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City | NORTHGLENN
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State | CO
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Zip | 80234-4126
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Country | US
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Telephone | 720-295-7548
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Fax |
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Provider Business Mailing Address
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Address Line | 5460 WARD RD STE 150
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City | ARVADA
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State | CO
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Zip | 80002-1828
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Country | US
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Telephone | 720-795-7548
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | VICKI SAYRE
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Credential |
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Telephone | 720-989-0021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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