Provider Demographics
NPI:1184249831
Name:THERAPEUTIC INTERVENTIONS LLC
Entity type:Organization
Organization Name:THERAPEUTIC INTERVENTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKERILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-425-7771
Mailing Address - Street 1:16270 FOREST LIGHT DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2074
Mailing Address - Country:US
Mailing Address - Phone:719-644-1119
Mailing Address - Fax:
Practice Address - Street 1:16270 FOREST LIGHT DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-2074
Practice Address - Country:US
Practice Address - Phone:719-644-1119
Practice Address - Fax:719-427-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty