NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC (NPI# 1659794477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659794477 |
| Entity Type | Organization |
| Organization Name | NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC |
| Practice Address |
4115 Boardwalk Drive, Suite 100 Fort Collins CO 80525-5945 |
| Mailing Address |
4115 Boardwalk Dr Suite 100 Fort Collins CO 80525-5945 |
| Practice Telephone | 9704934580 |
| Practice Fax Number | 9707972859 |
| Mailing Telephone | 9704934580 |
| Mailing Fax Number | 9707972859 |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2015-09-08 |
| Authorized Official Name | LISA PENDLETON (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 9704934580 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106H00000X | Marriage & Family Therapist | 974 | CO | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 983 | CO | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
12332 | CO | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
9923938 | CO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760043897 | Neurofeedback Clinic of Northern Colorado LLC | Counselor | 8203 W 20th St, Greeley, CO 80634-4696 | 2019-06-28 |
| Street Address |
4115 BOARDWALK DRIVE, SUITE 100 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-5945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821364 | Faith Nielsen | Social Worker | 812 Mcgraw Dr, Fort Collins, CO 80526-3977 | 2020-11-04 |
| 1073112223 | Sarah Laub | Social Worker | 2620 Red Fox Ct, Fort Collins, CO 80526-5285 | 2020-10-20 |
| 1427661164 | Nicholas Boeder - Lcsw | Social Worker | 3921 Bingham Hill Rd, Fort Collins, CO 80521-1025 | 2020-08-24 |
| 1629680202 | Amber Kelly Franzel | Social Worker | 1501 Blue Spruce Dr, Fort Collins, CO 80524-2004 | 2020-08-17 |
| 1215561857 | Transform The Nest LLC | Social Worker | 405 A Matthews Street, Fort Collins, CO 80524 | 2020-02-22 |
| 1376176099 | Cassie Marie Cyr | Social Worker | 1523 Silvergate Rd, Fort Collins, CO 80526-3302 | 2020-02-21 |
| 1659927309 | Ann Robinson | Social Worker | 2431 Cheviot Dr, Fort Collins, CO 80526-1479 | 2019-08-16 |
| 1013475748 | A Life Empowered, LLC | Social Worker | 612 Powderhorn Dr, Fort Collins, CO 80526-2607 | 2019-03-12 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1447733266 | Jessica R Mady | Social Worker | 418 Dunne Dr, Fort Collins, CO 80525-5847 | 2018-09-07 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
Please comment or provide details below to improve the information on NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.