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General NPI Number Information
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NPI Number | 1982588406
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Entity Type | Organization
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Legal Business Name | BOLD COLLECTIVE
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 1500 N GRANT ST STE R
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City | DENVER
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State | CO
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Zip | 80203-1859
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Country | US
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Telephone | 252-378-8849
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 141
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City | FORT KNOX
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State | KY
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Zip | 40121-0141
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | BRITTANY HARRIS-EAVES
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Credential | LCSW
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Telephone | 719-460-6513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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