Provider Demographics
NPI:1225481757
Name:CONNECT & THRIVE THERAPY, LLC
Entity Type:Organization
Organization Name:CONNECT & THRIVE THERAPY, LLC
Other - Org Name:COLORADO TEEN THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMERS-WEGIENKA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-441-3714
Mailing Address - Street 1:7200 S. ALTON WAY
Mailing Address - Street 2:SUITE A250
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:720-441-3714
Mailing Address - Fax:720-441-3714
Practice Address - Street 1:7200 S. ALTON WAY
Practice Address - Street 2:SUITE A250
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:720-441-3714
Practice Address - Fax:720-441-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012705101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty