| Amavi Integrative Mental Wellness Llc | |
|
6897 Paiute Ave Ste 5 Niwot CO 80503-7169 | |
| (303) 960-2269 | |
| (877) 839-3864 |
| Full Name | Amavi Integrative Mental Wellness Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 6897 Paiute Ave Ste 5, Niwot, Colorado |
| Authorized Official Name and Position | Elliot S Good (OWNER OF ENTITY) |
| Authorized Official Contact | 3039602269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amavi Integrative Mental Wellness Llc 6897 Paiute Ave Ste 5 Niwot CO 80503-7169 Ph: (303) 960-2269 | Amavi Integrative Mental Wellness Llc 6897 Paiute Ave Ste 5 Niwot CO 80503-7169 Ph: (303) 960-2269 |
| NPI Number | 1841823994 |
|---|---|
| Provider Enumeration Date | 02/18/2020 |
| Last Update Date | 02/18/2020 |
| Certification Date | 02/18/2020 |
| Medicare PECOS PAC ID | 4082043401 |
|---|---|
| Medicare Enrollment ID | O20200407001389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841823994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Erika Qualls Laing |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235413931 PECOS PAC ID: 7012181431 Enrollment ID: I20111122000196 |
| Provider Name | Elliot Good |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134540149 PECOS PAC ID: 1254513435 Enrollment ID: I20140221000404 |
| Provider Name | Kristin Wingfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568622694 PECOS PAC ID: 2062732332 Enrollment ID: I20150528000766 |
| Provider Name | Kathryn S Andres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457673303 PECOS PAC ID: 7113298191 Enrollment ID: I20170809002919 |
| Provider Name | Ashley Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407100571 PECOS PAC ID: 0648590414 Enrollment ID: I20180928001454 |
| Provider Name | Carol Anne Calkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245789692 PECOS PAC ID: 8022439165 Enrollment ID: I20200528001351 |
| Provider Name | Susan Marie Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154555092 PECOS PAC ID: 2769803717 Enrollment ID: I20200601000513 |
| Provider Name | Timothy Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215401351 PECOS PAC ID: 3577983980 Enrollment ID: I20201022003608 |
| Provider Name | Tamara Anne Bockman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225633480 PECOS PAC ID: 4183039498 Enrollment ID: I20210219000298 |
| Provider Name | Jeremy Benton Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538767389 PECOS PAC ID: 6305254939 Enrollment ID: I20210421000718 |
| Provider Name | Michael Phillip Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134704158 PECOS PAC ID: 4688082100 Enrollment ID: I20210422001835 |
| Provider Name | Gregory Lynn Styles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588858633 PECOS PAC ID: 5496164469 Enrollment ID: I20210503002185 |
| Provider Name | Mervi Buchler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952936460 PECOS PAC ID: 4688079387 Enrollment ID: I20210818002404 |
| Provider Name | Monique Marie Rees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982955738 PECOS PAC ID: 5991191074 Enrollment ID: I20220330001770 |
| Provider Name | Heide Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689902793 PECOS PAC ID: 3476949991 Enrollment ID: I20220411001404 |
| Provider Name | Jamie K Mccartney Herbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679062855 PECOS PAC ID: 0840677696 Enrollment ID: I20220517000038 |
| Provider Name | Jennifer Ann Gerardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700584174 PECOS PAC ID: 8729452032 Enrollment ID: I20230328000039 |
| Provider Name | Rhiannon Brey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265132450 PECOS PAC ID: 2668847161 Enrollment ID: I20230414002382 |
| Provider Name | Sean Patrick Mcnamara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437807419 PECOS PAC ID: 0345696324 Enrollment ID: I20231026004075 |
| Provider Name | Sherissa-nicole Martinez Sebastian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487313698 PECOS PAC ID: 2264876036 Enrollment ID: I20240220003053 |
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