The Other Therapy Online, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

THE OTHER THERAPY ONLINE, LLC

Practice address

1650 38TH St Ste 100E
Boulder, CO 80301-2624

Phone

(970) 319-7190

NPI assigned

Jul 21, 2023

Last updated

Jul 21, 2023By 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

Trevor BrownNPI 1730645235

Title

Ceo

Phone

(970) 319-7190

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Trevor M Brown

  • Mental Health Counselor
  • Boulder, CO
  • NPI 1730645235

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1063192276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CHERRY LN",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816219102",
            "telephone_number": "970-319-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 38TH ST STE 100E",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012624",
            "telephone_number": "970-319-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OTHER THERAPY ONLINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-319-7190"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.