Organization Active NPI

Broadvistas Psychology LLC

  • Clinical Psychologist
  • Highlands Ranch, CO
National Provider Identifier
1326422759
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0004234 Issued in CO
Legal business name
BROADVISTAS PSYCHOLOGY LLC
Practice address
3420 Mill Vista Rd
Highlands Ranch, CO 80129-2324
Phone
(888) 948-6789
Fax
(877) 345-3501
NPI assigned
Jul 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
Thomas Broadhurst, PSYD
Title
Psychologist
Phone
(720) 838-8141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY.0004234 CO Primary

Addresses

Primary practice location

3420 Mill Vista Rd
Highlands Ranch, CO 80129-2324

Mailing address

1 Kalisa Way Ste 101
Paramus, NJ 07652-3508
Phone (888) 948-6789

Other identifiers 1

IdentifierTypeStateIssuer
PSY.0004234OtherCOPROFESSIONAL LICENSE

National Provider Directory

National Provider Directory

Locations

3420 Mill Vista Rd
Highlands Ranch, CO 80129
Phone (303) 798-3100

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1326422759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY STE 101",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523508",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 MILL VISTA RD",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292324",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADVISTAS PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "BROADHURST",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "720-838-8141",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "PSY.0004234",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.