Provider Demographics
NPI:1124893870
Name:RIVERBED PSYCHOLOGY, PLLC
Entity type:Organization
Organization Name:RIVERBED PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:
Authorized Official - Last Name:MEASON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:970-270-8928
Mailing Address - Street 1:580 MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-2065
Mailing Address - Country:US
Mailing Address - Phone:303-276-9234
Mailing Address - Fax:
Practice Address - Street 1:1557 N OGDEN ST STE 6
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1489
Practice Address - Country:US
Practice Address - Phone:303-276-9234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty