| Innerchange Vive | |
| 1150 Maxwell Ave Suite 200 Boulder CO 80304-4185 | |
| (303) 449-2516 | |
| (303) 449-4341 | 
| Full Name | Innerchange Vive | 
|---|---|
| Speciality | Social Worker - Clinical | 
| Location | 1150 Maxwell Ave, Boulder, Colorado | 
| Authorized Official Name and Position | Laura J Brown (VP OF REVENUE CYCLE MANAGEMENT) | 
| Authorized Official Contact | 6618294060 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Innerchange Vive 5500 Ming Ave Ste 410 Bakersfield CA 93309-4631 Ph: (661) 622-4132 | Innerchange Vive 1150 Maxwell Ave Suite 200 Boulder CO 80304-4185 Ph: (303) 449-2516 | 
| NPI Number | 1265891162 | 
|---|---|
| Provider Enumeration Date | 02/19/2016 | 
| Last Update Date | 06/20/2023 | 
| Certification Date | 06/20/2023 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1265891162 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary | 
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