Provider Demographics
NPI:1225702616
Name:COLORADO THERAPY GROUP, LLC
Entity Type:Organization
Organization Name:COLORADO THERAPY GROUP, LLC
Other - Org Name:COLORADO THERAPY GROUP, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELEONORA
Authorized Official - Middle Name:V
Authorized Official - Last Name:JULIANA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT, LAC
Authorized Official - Phone:720-203-2887
Mailing Address - Street 1:6795 E TENNESSEE AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1693
Mailing Address - Country:US
Mailing Address - Phone:720-203-2887
Mailing Address - Fax:
Practice Address - Street 1:6795 E TENNESSEE AVE STE 370
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1693
Practice Address - Country:US
Practice Address - Phone:720-203-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20211731326OtherNON-MEDICARE