=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891583928
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEAD, HEART & HOUND THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2025
-----------------------------------------------------
Last Update Date | 04/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1460 PIERCE ST
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80214-1941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-588-3713
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9793 FOXHILL CIR
-----------------------------------------------------
City | HIGHLANDS RANCH
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80129-4304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-933-7472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | ANNA MILLER
-----------------------------------------------------
Credential | LCSW, AASW, CAAP
-----------------------------------------------------
Telephone | 720-588-3713
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------