Provider Demographics
NPI:1295028041
Name:EXPRESSIVE THERAPIES LLC
Entity Type:Organization
Organization Name:EXPRESSIVE THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ELLA
Authorized Official - Last Name:DONARS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-635-0025
Mailing Address - Street 1:825 E SPEER BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3719
Mailing Address - Country:US
Mailing Address - Phone:720-635-0025
Mailing Address - Fax:
Practice Address - Street 1:825 E SPEER BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3719
Practice Address - Country:US
Practice Address - Phone:720-635-0025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5383101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty