Provider Demographics
NPI:1780191908
Name:NOVA THERAPY PLLC.
Entity Type:Organization
Organization Name:NOVA THERAPY PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOWOSIELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MFTC
Authorized Official - Phone:303-588-2585
Mailing Address - Street 1:2806 N SPEER BLVD STE 3A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4225
Mailing Address - Country:US
Mailing Address - Phone:303-588-2585
Mailing Address - Fax:
Practice Address - Street 1:2806 N SPEER BLVD STE 3A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4225
Practice Address - Country:US
Practice Address - Phone:303-588-2585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health