Provider Demographics
NPI:1871041947
Name:HEARTBEAT THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:HEARTBEAT THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCGEOWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-438-1577
Mailing Address - Street 1:PO BOX 6303
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-2078
Mailing Address - Country:US
Mailing Address - Phone:720-438-1577
Mailing Address - Fax:303-772-3539
Practice Address - Street 1:16 MOUNTAIN VIEW AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3420
Practice Address - Country:US
Practice Address - Phone:720-438-1577
Practice Address - Fax:303-772-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0003057261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health