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Organization
DIGITAL MEDIA TREATMENT AND EDUCATION CENTER, LLC
Active
Organization
DIGITAL MEDIA TREATMENT AND EDUCATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT KENNEDY PSY.D. (OWNER, CO-DIRECTOR)
(303) 632-8883
Entity
Organization
Contact information
Practice address
2299 PEARL ST STE 310, BOULDER, CO 80302-4671
(303) 635-6753
(303) 593-1058
Mailing address
2299 PEARL ST STE 310, BOULDER, CO 80302-4671
(303) 635-6753
(303) 593-1058
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
—
—
103TF0000X
Family Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326345216
—
CO
05
—
1639234545
—
NY
Enumeration date
06/30/2019
Last updated
06/30/2019
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