Provider Demographics
NPI:1457461808
Name:ALPINE BEHAVIOR THERAPY CLINIC
Entity Type:Organization
Organization Name:ALPINE BEHAVIOR THERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:970-482-7771
Mailing Address - Street 1:1918 S LEMAY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1294
Mailing Address - Country:US
Mailing Address - Phone:970-482-7771
Mailing Address - Fax:970-482-7776
Practice Address - Street 1:1918 S LEMAY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1294
Practice Address - Country:US
Practice Address - Phone:970-482-7771
Practice Address - Fax:970-482-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3290101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty