Indepth Therapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INDEPTH THERAPY, LLC

Practice address

1008 Depot Hill Rd Ste 200
Broomfield, CO 80020-6724

Phone

(720) 232-2303

Fax

(720) 358-0846

NPI assigned

Feb 12, 2016

Last updated

Mar 1, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bethany Blankenheim, LPCNPI 1255463386

Title

Co-Owner

Phone

(720) 232-2303

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Tax ID family

Indepth Therapy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Indepth Therapy, LLC

  • Professional Counselor
  • Lakewood, CO
  • NPI 1124635867
  NPD tax ID
• Indepth Therapy, LLC

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1558978452
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Indepth Therapy, LLC

  • Professional Counselor
  • Lakewood, CO
  • NPI 1124635867
  NPPES parent name
• Indepth Therapy, LLC

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1558978452
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bethany Blankenheim, LPC, CACII

  • Professional Counselor
  • Broomfield, CO
  • NPI 1255463386
  Medicare reassignment NPD Authorized official
• Sally Morgan, LPC

  • Mental Health Counselor
  • Broomfield, CO
  • NPI 1073956116

  Professional

  NPD (past)
• Maria Niichel

  • Mental Health Counselor
  • Broomfield, CO
  • NPI 1295326049
  NPD (past)
• Jaime E Smith, LCSW

  • Clinical Social Worker
  • Broomfield, CO
  • NPI 1144875196
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1003275439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 DEPOT HILL RD STE 200",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800206724",
            "telephone_number": "720-232-2303",
            "fax_number": "720-358-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 DEPOT HILL RD STE 200",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800206724",
            "telephone_number": "720-232-2303",
            "fax_number": "720-358-0846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 W 6th Ave",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800201870",
            "country_code": "US",
            "telephone_number": "720-232-2303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDEPTH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "BLANKENHEIM",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "720-232-2303",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.