Organization
BOULDER VALLEY PSYCHOTHERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER T WHITTALL PSYD (PRESIDENT/PSYCHOLOGIST)
(720) 591-4664
Entity
Organization
Contact information
Practice address
1800 30TH ST STE 212, BOULDER, CO 80301-1087
(720) 591-6444
Mailing address
400 E SIMPSON ST. #104, LAFAYETTE, CO 80026-2359
(720) 591-6444
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79600573
—
CO
Enumeration date
05/24/2018
Last updated
12/26/2024
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