Provider Demographics
NPI:1811727720
Name:THORNWOODWELLNESSLLC
Entity type:Organization
Organization Name:THORNWOODWELLNESSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRUNICK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:303-908-5560
Mailing Address - Street 1:620 FRONT RANGE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4052
Mailing Address - Country:US
Mailing Address - Phone:303-908-5560
Mailing Address - Fax:
Practice Address - Street 1:3303 W 144TH AVE UNIT 204
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-9601
Practice Address - Country:US
Practice Address - Phone:303-908-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty