Provider Demographics
NPI:1194583104
Name:TWO DOORS DOWN PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:TWO DOORS DOWN PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:SWAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-769-6792
Mailing Address - Street 1:1975 30TH ST APT 115
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3067
Mailing Address - Country:US
Mailing Address - Phone:206-769-6792
Mailing Address - Fax:206-299-9588
Practice Address - Street 1:1975 30TH ST APT 115
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3067
Practice Address - Country:US
Practice Address - Phone:206-769-6792
Practice Address - Fax:206-299-9588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty