| Neurobloom Counseling And Neurofeedback, Llc | |
|
13654 Xavier Ln Ste 201 Broomfield CO 80023-3608 | |
| (720) 523-1067 | |
| Not Available |
| Full Name | Neurobloom Counseling And Neurofeedback, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13654 Xavier Ln Ste 201, Broomfield, Colorado |
| Authorized Official Name and Position | Tanja Gorenc (LICENSED MARRIAGE AND FAMILY THERAP) |
| Authorized Official Contact | 7205231067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurobloom Counseling And Neurofeedback, Llc 13654 Xavier Ln Ste 201 Broomfield CO 80023-3608 Ph: (720) 523-1067 | Neurobloom Counseling And Neurofeedback, Llc 13654 Xavier Ln Ste 201 Broomfield CO 80023-3608 Ph: (720) 523-1067 |
| NPI Number | 1912592452 |
|---|---|
| Provider Enumeration Date | 03/06/2021 |
| Last Update Date | 10/04/2023 |
| Certification Date | 10/04/2023 |
| Medicare PECOS PAC ID | 0345680500 |
|---|---|
| Medicare Enrollment ID | O20240504000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912592452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tanja Gorenc |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1629422662 PECOS PAC ID: 1254771413 Enrollment ID: I20240504000375 |
| Provider Name | Sarah Kraft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245873512 PECOS PAC ID: 6103268271 Enrollment ID: I20240522000318 |
| Provider Name | Courtney Rae Demers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710537824 PECOS PAC ID: 6608218102 Enrollment ID: I20240529004038 |
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