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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