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General NPI Number Information
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NPI Number | 1669214193
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Entity Type | Organization
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Legal Business Name | BRIEF PSYCHOTHERAPY INSTITUTE LLC
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 1022 DEPOT HILL RD
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City | BROOMFIELD
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State | CO
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Zip | 80020-1068
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Country | US
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Telephone | 720-640-1910
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Fax | 303-664-1651
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Provider Business Mailing Address
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Address Line | 9770 ISABELLE RD
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City | LAFAYETTE
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State | CO
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Zip | 80026-9104
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Country | US
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Telephone | 720-640-1910
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Fax | 303-664-1651
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Authorized Official
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Title or Position | OWNER
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Name | DAVID LEISTIKOW
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Credential | MD
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Telephone | 303-549-4076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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