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Contact Information

PH BALANCE BEHAVIORAL
954 5TH AVE
LONGMONT, CO80501-5424
 Phone: 720-410-4529
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Analyst

103K00000X
 

Assistant Behavior Analyst

106E00000X
 

Behavior Technician

106S00000X
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Health Service

103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PH BALANCE BEHAVIORAL

NPI Number 1598399115
LBN Legal business name PH BALANCE BEHAVIORAL
Authorized official BRANDON PEREA-HICKAM - (FOUNDER AND CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/24/2020
Last updated 10/04/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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