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General NPI Number Information
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NPI Number | 1497546402
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Entity Type | Organization
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Legal Business Name | STATION THERAPY LLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 12211 W ALAMEDA PKWY STE 201
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City | LAKEWOOD
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State | CO
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Zip | 80228-2825
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Country | US
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Telephone | 720-767-2229
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Fax |
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Provider Business Mailing Address
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Address Line | 1942 BROADWAY STE 314C
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City | BOULDER
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State | CO
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Zip | 80302-5233
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Country | US
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Telephone | 720-767-2229
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | CAMERON RAY GONZALES
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Credential | MFT-C
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Telephone | 720-767-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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