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General NPI Number Information
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NPI Number | 1891316519
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Entity Type | Organization
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Legal Business Name | STRIVE PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 2299 PEARL ST STE 310
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City | BOULDER
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State | CO
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Zip | 80302-4671
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Country | US
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Telephone | 720-443-1889
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Fax | 720-647-9120
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Provider Business Mailing Address
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Address Line | 2299 PEARL ST STE 310
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City | BOULDER
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State | CO
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Zip | 80302-4671
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Country | US
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Telephone | 720-443-1889
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Fax | 720-647-9120
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Authorized Official
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Title or Position | OWNER, CO-DIRECTOR
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Name | BRETT P KENNEDY
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Credential | PSY.D.
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Telephone | 720-328-5305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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