Provider Demographics
NPI:1104669589
Name:BJERUM THERAPY
Entity type:Organization
Organization Name:BJERUM THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BJERUM
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW, LCAC, LCSW
Authorized Official - Phone:316-772-6320
Mailing Address - Street 1:1905 SHERMAN STREET
Mailing Address - Street 2:STE 200 #1199
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203
Mailing Address - Country:US
Mailing Address - Phone:316-772-6320
Mailing Address - Fax:719-259-3140
Practice Address - Street 1:8838 CULEBRA ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-7334
Practice Address - Country:US
Practice Address - Phone:316-772-6320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health