Provider Demographics
NPI:1568287910
Name:CONTEMPLATIVE CAREGIVER LLC
Entity type:Organization
Organization Name:CONTEMPLATIVE CAREGIVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:K
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC, NLC
Authorized Official - Phone:720-776-9924
Mailing Address - Street 1:2616 JUNIPER AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2468
Mailing Address - Country:US
Mailing Address - Phone:720-776-9924
Mailing Address - Fax:
Practice Address - Street 1:4710 TABLE MESA DR STE B
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-4504
Practice Address - Country:US
Practice Address - Phone:720-776-9924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty