Provider Demographics
NPI:1164433603
Name:BRAIN MATTERS, INC.
Entity Type:Organization
Organization Name:BRAIN MATTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:SHIELDS
Authorized Official - Last Name:GOODHUE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:720-941-6428
Mailing Address - Street 1:201 UNIVERSITY BLVD
Mailing Address - Street 2:#200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4657
Mailing Address - Country:US
Mailing Address - Phone:720-941-6428
Mailing Address - Fax:720-941-6494
Practice Address - Street 1:201 UNIVERSITY BLVD
Practice Address - Street 2:#200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4657
Practice Address - Country:US
Practice Address - Phone:720-941-6428
Practice Address - Fax:720-941-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9915221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty