Provider Demographics
NPI:1366536054
Name:BT PROFESSIONAL CARE SERVICES, LLC
Entity type:Organization
Organization Name:BT PROFESSIONAL CARE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:TYNDALL
Authorized Official - Last Name:MCCUBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:303-619-0927
Mailing Address - Street 1:12000 WASHINGTON ST
Mailing Address - Street 2:STE 325
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3155
Mailing Address - Country:US
Mailing Address - Phone:303-619-0927
Mailing Address - Fax:303-759-3949
Practice Address - Street 1:12000 WASHINGTON ST
Practice Address - Street 2:STE 325
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3155
Practice Address - Country:US
Practice Address - Phone:303-619-0927
Practice Address - Fax:303-759-3949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4070101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty