Provider Demographics
NPI:1831863919
Name:LOGOS THERAPEUTICS PSYCHOTHERAPY & MEDICATION MANAGEMENT, LLC
Entity type:Organization
Organization Name:LOGOS THERAPEUTICS PSYCHOTHERAPY & MEDICATION MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:303-587-1865
Mailing Address - Street 1:10035 E 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-3903
Mailing Address - Country:US
Mailing Address - Phone:303-587-1865
Mailing Address - Fax:
Practice Address - Street 1:7010 BROADWAY STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-2921
Practice Address - Country:US
Practice Address - Phone:303-650-1070
Practice Address - Fax:303-650-5970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty