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General NPI Number Information
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NPI Number | 1740316975
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR CHANGE, P.C.
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 3500 S WADSWORTH BLVD 403
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City | LAKEWOOD
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State | CO
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Zip | 80235-2019
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Country | US
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Telephone | 303-933-9104
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 S WADSWORTH BLVD 403
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City | LAKEWOOD
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State | CO
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Zip | 80235-2019
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Country | US
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Telephone | 303-933-9104
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES D THOMAS
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Credential | LMFT
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Telephone | 303-933-9104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 247
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License Number State | CO
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