Organization
MY THERAPY MATTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIVE RUSSELL HALLAM LMFT (CHIEF EXECUTIVE OFFICER)
(719) 404-6618
Entity
Organization
Contact information
Practice address
445 S LAPORTE DR, PUEBLO WEST, CO 81007-1572
(719) 404-6618
Mailing address
1094 S GREENWAY DR, PUEBLO WEST, CO 81007-5092
(435) 817-0155
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48800074
—
CO
Enumeration date
01/26/2021
Last updated
11/12/2025
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