Provider Demographics
NPI:1184176067
Name:NEUROWORKS LLC
Entity type:Organization
Organization Name:NEUROWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-744-0577
Mailing Address - Street 1:255 CANYON BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-4954
Mailing Address - Country:US
Mailing Address - Phone:720-744-0577
Mailing Address - Fax:720-638-3699
Practice Address - Street 1:255 CANYON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4954
Practice Address - Country:US
Practice Address - Phone:303-945-5311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3125103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84575379Medicaid
CO84575379Medicaid