Organization
BROADVISTAS PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS BROADHURST PSYD (PSYCHOLOGIST)
(720) 838-8141
Entity
Organization
Contact information
Practice address
3420 MILL VISTA RD, HIGHLANDS RANCH, CO 80129-2324
(888) 948-6789
(877) 345-3501
Mailing address
1 KALISA WAY STE 101, PARAMUS, NJ 07652-3508
(888) 948-6789
(877) 345-3501
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY.0004234
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY.0004234
PROFESSIONAL LICENSE
CO
Enumeration date
07/15/2015
Last updated
08/04/2025
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