Indepth Therapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INDEPTH THERAPY, LLC

Practice address

3307 S College Ave Unit 217
Fort Collins, CO 80525-4196

Phone

(720) 538-4357

Fax

(720) 358-0846

NPI assigned

Sep 25, 2020

Last updated

Sep 6, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

INDEPTH THERAPY, LLCAs reported in NPPES

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

Authorized official

Name

Bethany BlankenheimNPI 1255463386

Title

Owner

Phone

(720) 232-2303

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

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

Part of

Indepth Therapy LLC

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
  • Broomfield, CO
  • NPI 1003275439
  NPD tax ID
• Indepth Therapy, LLC

  • Professional Counselor
  • Lakewood, CO
  • NPI 1124635867
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Indepth Therapy, LLC

  • Professional Counselor
  • Broomfield, CO
  • NPI 1003275439
  NPPES parent name

Practitioners 2

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
  NPD (past) Authorized official
• Maria Niichel

  • Mental Health Counselor
  • Broomfield, CO
  • NPI 1295326049
  NPD

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1558978452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 DEPOT HILL RD # 201",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800206723",
            "telephone_number": "720-232-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 S COLLEGE AVE UNIT 217",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254196",
            "telephone_number": "720-538-4357",
            "fax_number": "720-358-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPTH THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPTH THERAPY, LLC",
        "enumeration_date": "2020-09-25",
        "last_updated": "2023-09-06",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "BLANKENHEIM",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-232-2303"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59112557",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.