Provider Demographics
NPI:1093905549
Name:L BRIAN HERSCH & ASSOCIATES A PROFESSIONAL LLC
Entity Type:Organization
Organization Name:L BRIAN HERSCH & ASSOCIATES A PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:HERSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-637-1739
Mailing Address - Street 1:4789 BRIAR RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3902
Mailing Address - Country:US
Mailing Address - Phone:303-637-1739
Mailing Address - Fax:303-530-7856
Practice Address - Street 1:4789 BRIAR RIDGE TRL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3902
Practice Address - Country:US
Practice Address - Phone:303-637-1739
Practice Address - Fax:303-530-7856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO172772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty