Provider Demographics
NPI:1275655805
Name:HEALTH PSYCHOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:HEALTH PSYCHOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:970-352-8311
Mailing Address - Street 1:1610 29TH AVENUE PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-6813
Mailing Address - Country:US
Mailing Address - Phone:970-352-8311
Mailing Address - Fax:970-356-9884
Practice Address - Street 1:1610 29TH AVENUE PL
Practice Address - Street 2:SUITE 200
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6813
Practice Address - Country:US
Practice Address - Phone:970-352-8311
Practice Address - Fax:970-356-9884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1123103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO804732Medicare ID - Type UnspecifiedGRP MEDICARE NUMBER