BROADVISTAS PSYCHOLOGY LLC (NPI# 1134743529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134743529 |
| Entity Type | Organization |
| Organization Name | BROADVISTAS PSYCHOLOGY LLC |
| Practice Address |
14555 E Hampden Ave Aurora CO 80014-5041 |
| Mailing Address |
4860 Robb St Ste 201 Wheat Ridge CO 80033-2162 |
| Practice Telephone | 8889486789 |
| Practice Fax Number | 8773453501 |
| Mailing Telephone | 3032787418 |
| Mailing Fax Number | 8773453501 |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | THOMAS JUDSON BROADHURST (OWNER) |
| Authorized Official Telephone | 3032787418 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699383109 | Broadvistas Psychology LLC | Psychologist | 1919 Quentin St, Aurora, CO 80045-7125 | 2020-07-21 |
| 1528682580 | Broadvistas Psychology LLC | Psychologist | 13525 E 23rd Ave, Aurora, CO 80045-7450 | 2020-06-04 |
| 1679197065 | Broadvistas Psychology LLC | Psychologist | 12230 Lioness Way, Parker, CO 80134-5603 | 2020-06-02 |
| 1114541406 | Broadvistas Psychology LLC | Psychologist | 8550 E Lowry Blvd, Denver, CO 80230-6932 | 2020-06-02 |
| 1326422759 | Broadvistas Psychology LLC | Psychologist | 1919 Quentin St, Aurora, CO 80045-7125 | 2015-07-15 |
| Street Address |
14555 E HAMPDEN AVE |
| City | AURORA |
| State | CO |
| Zip Code | 80014-5041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598043218 | Marty Lees Daugherty | Counselor | 14555 E Hampden Ave, Aurora, CO 80014-5041 | 2011-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942825021 | Dieuvil Varice | Occupational Therapist | 2851 S Parker Rd Ste 570, Aurora, Co, Aurora, CO 80014 | 2020-06-14 |
| 1518437144 | Curtis E Redd | Case Manager/Care Coordinator | 1059 E Bethany Dr, Suite 200, Aurora, CO 80014 | 2018-11-27 |
| 1144795154 | Prestige Adult Day Care LLC | Clinic/Center | 2860 S Havana St, Unit C, Aurora, CO 80014 | 2018-10-05 |
| 1609375492 | Jacob Mcbride | Behavior Technician | 2121 S Blackhawk St 100, Aurora, CO 80014 | 2018-02-07 |
| 1265931240 | Jasmine Nicole Joseph | Behavior Technician | 2121 S. Blackhawk St., Aurora, CO 80014 | 2018-02-06 |
| 1255830238 | Russel Talukder | Behavioral Analyst | 2121 South Blackhawk St 100, Aurora, CO 80014 | 2018-02-06 |
| 1467951442 | Dylan Kelley | Behavior Technician | 2121 Blackhawk St. Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1184123168 | Talisa Fisher | Behavior Technician | 2121 S Blackhawk St Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1144732314 | Hellen A Noamesi | Registered Nurse | Kaiser Water Park 1, 2500 S. Havana St, Aurora, CO 80014 | 2017-10-27 |
| 1255840641 | Amanda Dawn Thompson | Massage Therapist | 3035 South Parker Rd., 560 Building E, Aurora, CO 80014 | 2017-09-28 |
| Find all providers in zip 80014 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659980704 | Diana L. Slaviero, Ph.d., P.C. | Psychologist | 75 Executive Dr Ste 429, Aurora, IL 60504-8112 | 2020-07-24 |
| 1164066528 | Cynthia Guadalupe Penne | Psychologist | 2794 Rosehall Ln, Aurora, IL 60503-5682 | 2019-10-29 |
| 1669015913 | Briana Lucia Robustelli | Psychologist | 1700 Wheeling St # 554-116w, Aurora, CO 80045-7211 | 2019-10-18 |
| 1750899910 | Michael W Kirkwood | Psychologist | Dept of Rehab, B285; Children's Hospital Colorado, 13123 E. 16th Ave, Aurora, CO 80045 | 2018-01-22 |
| 1043731409 | Horizon Psychology Services, LLC | Psychologist | 2261 Reflections Dr, Aurora, IL 60502-7310 | 2017-07-06 |
| 1144626888 | Diana Hinojosa | Psychologist | 10680 Del Mar Pkwy, Aurora, CO 80010 | 2014-11-06 |
| 1639597446 | Todd Huenecke | Psychologist | 2135 Colonial St, Aurora, IL 60503-4611 | 2014-03-31 |
| 1932538717 | Erica Stephens | Psychologist | 3131 S Vaughn Way Ste 110, Aurora, CO 80014 | 2013-11-02 |
| 1588942585 | Charles Harrison | Psychologist | 13123 E 16th Ave # B505, Aurora, CO 80045-7106 | 2011-07-26 |
| 1619138070 | Irene Gutierrez Ellis | Psychologist | 2101 S Blackhawk St., Ste 240, Rm 4, Aurora, CO 80014-1475 | 2008-06-18 |
| Find all providers in AURORA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.