Provider Demographics
NPI:1689712713
Name:NEUROPSYCHOLOGICAL CONSULTANTS LLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGICAL CONSULTANTS LLC
Other - Org Name:THE BRAIN AND BEHAVIOR CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SCHMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-938-9244
Mailing Address - Street 1:2523 BROADWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-4240
Mailing Address - Country:US
Mailing Address - Phone:303-938-9244
Mailing Address - Fax:303-413-1308
Practice Address - Street 1:2523 BROADWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-4240
Practice Address - Country:US
Practice Address - Phone:303-938-9244
Practice Address - Fax:303-413-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1242174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC803100Medicare PIN