Provider Demographics
NPI:1013771526
Name:PURE POTENTIAL THERAPEUTIC SERVICES, LLC
Entity Type:Organization
Organization Name:PURE POTENTIAL THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:303-881-3377
Mailing Address - Street 1:7955 E ARAPAHOE CT STE 1425
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6848
Mailing Address - Country:US
Mailing Address - Phone:303-881-3377
Mailing Address - Fax:
Practice Address - Street 1:8354 E NORTHFIELD BLVD STE 313
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3131
Practice Address - Country:US
Practice Address - Phone:303-881-3377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty