Provider Demographics
NPI:1669008314
Name:DR. SUNDA FRIEDMAN TEBOCKHORST PSYCHOLOGICL SERVICES, LTD
Entity Type:Organization
Organization Name:DR. SUNDA FRIEDMAN TEBOCKHORST PSYCHOLOGICL SERVICES, LTD
Other - Org Name:METIS CENTER FOR PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNDA
Authorized Official - Middle Name:FRIEDMAN
Authorized Official - Last Name:TEBOCKHORST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:720-387-8458
Mailing Address - Street 1:588 N HWY 287
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026
Mailing Address - Country:US
Mailing Address - Phone:720-387-8458
Mailing Address - Fax:
Practice Address - Street 1:1300 PLAZA CT N STE 103
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1467
Practice Address - Country:US
Practice Address - Phone:720-387-8458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1547857677OtherNPI