Provider Demographics
NPI:1982272043
Name:SILVER MOUNTAIN PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:SILVER MOUNTAIN PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-772-8283
Mailing Address - Street 1:3967 COUNTY ROAD 116
Mailing Address - Street 2:
Mailing Address - City:HESPERUS
Mailing Address - State:CO
Mailing Address - Zip Code:81326-9482
Mailing Address - Country:US
Mailing Address - Phone:646-772-8283
Mailing Address - Fax:
Practice Address - Street 1:2257 MAIN AVE STE D
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4660
Practice Address - Country:US
Practice Address - Phone:970-239-1791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SILVER MOUNTAIN PSYCHOTHERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-15
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty