Provider Demographics
NPI:1144992702
Name:ATLAS PSYCHOLOGY
Entity type:Organization
Organization Name:ATLAS PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEIL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-945-8133
Mailing Address - Street 1:2500 30TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1258
Mailing Address - Country:US
Mailing Address - Phone:310-945-8133
Mailing Address - Fax:
Practice Address - Street 1:2500 30TH ST STE 206
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1258
Practice Address - Country:US
Practice Address - Phone:310-945-8133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center