Provider Demographics
NPI:1871118117
Name:NEW GROWTH THERAPY LLC
Entity type:Organization
Organization Name:NEW GROWTH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MBR
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLA
Authorized Official - Middle Name:F
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-282-1727
Mailing Address - Street 1:350 EAST STREET #56
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-0056
Mailing Address - Country:US
Mailing Address - Phone:720-282-1727
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:491 W SPRING STREET
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:CO
Practice Address - Zip Code:80466
Practice Address - Country:US
Practice Address - Phone:720-282-1727
Practice Address - Fax:866-757-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000183797Medicaid