| Boulder Center For Tms Llc | |
|
2501 Walnut St Suite 207 Boulder CO 80302-5751 | |
| (303) 449-0318 | |
| (303) 442-1125 |
| Full Name | Boulder Center For Tms Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2501 Walnut St, Boulder, Colorado |
| Authorized Official Name and Position | Richard Lee Suddath (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3034447228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulder Center For Tms Llc 2501 Walnut St Suite 207 Boulder CO 80302-5751 Ph: (303) 449-0318 | Boulder Center For Tms Llc 2501 Walnut St Suite 207 Boulder CO 80302-5751 Ph: (303) 449-0318 |
| NPI Number | 1992236319 |
|---|---|
| Provider Enumeration Date | 03/27/2017 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 3678014362 |
|---|---|
| Medicare Enrollment ID | O20240920003529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992236319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25705 (Colorado) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25131 (Colorado) | Secondary |
| Provider Name | Emma Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023755212 PECOS PAC ID: 2264818509 Enrollment ID: I20240920003579 |
| Provider Name | Rebecca Kass |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528696333 PECOS PAC ID: 4082057401 Enrollment ID: I20240920003599 |
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