Provider Demographics
NPI:1316676877
Name:MY SEASONS THERAPY, LLC
Entity type:Organization
Organization Name:MY SEASONS THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN HIATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-998-6276
Mailing Address - Street 1:11224 QUIVAS LOOP
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2615
Mailing Address - Country:US
Mailing Address - Phone:303-547-2313
Mailing Address - Fax:
Practice Address - Street 1:2095 W 6TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1880
Practice Address - Country:US
Practice Address - Phone:720-998-6276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty