Neurotherapy Center of Northern Colorado, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

992151 Issued in CO

Legal business name

NEUROTHERAPY CENTER OF NORTHERN COLORADO, LLC

Practice address

503 Remington St Ste 106
Fort Collins, CO 80524-3089

Phone

(970) 214-5712

Fax

(970) 315-0386

NPI assigned

Mar 8, 2011

Last updated

Mar 8, 2011By 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

Ms. Michaele Dawn Johnson, LCSW

Title

Sole Owner

Phone

(970) 214-5712

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1093013526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 REMINGTON ST STE 106",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243089",
            "telephone_number": "970-214-5712",
            "fax_number": "970-315-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 REMINGTON ST STE 106",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243089",
            "telephone_number": "970-214-5712",
            "fax_number": "970-315-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTHERAPY CENTER OF NORTHERN COLORADO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHAELE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "970-214-5712",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CO",
            "license": "992151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "COA100486",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "COA100485",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neurofeedback Clinic of Northern Colorado LLC
• Neurofocus PLLC
• Neurology Specialists of the Rockies, LLC
• Neuropsychological Consults of Northern Colorado LLC
• Neurosong Music Therapy Services, Inc.
• Hali Neves, MA, LPC
• Christine Rose Nevin-Woods, D.O.
• Thomas E Nevrivy, M.D.
• New Belgium Brewing Company, Inc.
• New Horizon Assisted Living (Seneca House Assisted Living)

• Adult Mental Health Clinic/Center in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Adult Mental Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.