| Umbrella Collective Inc | |
|
2919 Valmont Road Ste 104 Boulder CO 80301-1350 | |
| (720) 663-0163 | |
| (303) 658-9871 |
| Full Name | Umbrella Collective Inc |
|---|---|
| Speciality | Social Worker |
| Location | 2919 Valmont Road, Boulder, Colorado |
| Authorized Official Name and Position | Li Brookens (OWNER) |
| Authorized Official Contact | 7206630163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Umbrella Collective Inc 2919 Valmont Road Ste 104 Boulder CO 80301-1350 Ph: (720) 663-0163 | Umbrella Collective Inc 2919 Valmont Road Ste 104 Boulder CO 80301-1350 Ph: (720) 663-0163 |
| NPI Number | 1881045326 |
|---|---|
| Provider Enumeration Date | 06/27/2016 |
| Last Update Date | 11/09/2021 |
| Certification Date | 11/09/2021 |
| Medicare PECOS PAC ID | 7618376781 |
|---|---|
| Medicare Enrollment ID | O20210521000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881045326 | NPI | - | NPPES |
| 9000166630 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW.09923331 (Colorado) | Primary |
| Provider Name | Matthew Stephen Meurer-lynn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154839199 PECOS PAC ID: 5991065203 Enrollment ID: I20180206002183 |
| Provider Name | Li M Brookens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902228059 PECOS PAC ID: 7517366685 Enrollment ID: I20210524001390 |
| Provider Name | Katrina L Puente |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871923417 PECOS PAC ID: 9335540129 Enrollment ID: I20210630003450 |
| Provider Name | Suzanne E Pearson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669920625 PECOS PAC ID: 4880095678 Enrollment ID: I20210630003467 |
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