Provider Demographics
NPI:1598511586
Name:VIVIFY THERAPY
Entity type:Organization
Organization Name:VIVIFY THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:970-408-0363
Mailing Address - Street 1:3534 WHISPERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-2402
Mailing Address - Country:US
Mailing Address - Phone:315-873-2936
Mailing Address - Fax:
Practice Address - Street 1:3780 N GARFIELD AVE STE 202
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2237
Practice Address - Country:US
Practice Address - Phone:970-408-0363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty