Provider Demographics
NPI:1487221768
Name:MY DENVER THERAPY, INC.
Entity Type:Organization
Organization Name:MY DENVER THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEYROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPC, LAC
Authorized Official - Phone:720-504-4329
Mailing Address - Street 1:11301 MESA VERDE PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3010
Mailing Address - Country:US
Mailing Address - Phone:310-902-2930
Mailing Address - Fax:
Practice Address - Street 1:9233 PARK MEADOWS DR STE 121
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5698
Practice Address - Country:US
Practice Address - Phone:720-504-4329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1851892871OtherINDIVIDUAL NPI