| Reconstruct Psychotherapy, Llc | |
|
1495 Canyon Blvd Boulder CO 80302-5367 | |
| (800) 571-5613 | |
| Not Available |
| Full Name | Reconstruct Psychotherapy, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1495 Canyon Blvd, Boulder, Colorado |
| Authorized Official Name and Position | Christopher J Smallwood (CEO) |
| Authorized Official Contact | 5129958905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reconstruct Psychotherapy, Llc 4845 Pearl East Cir Ste 118 Pmb 38489 Boulder CO 80301 Ph: () - | Reconstruct Psychotherapy, Llc 1495 Canyon Blvd Boulder CO 80302-5367 Ph: (800) 571-5613 |
| NPI Number | 1518738012 |
|---|---|
| Provider Enumeration Date | 01/12/2024 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518738012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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