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EXTREME SPORTS CAMP
NPI 1669744637
Counselor in Basalt, CO

Active since February 06, 2012
23286 TWO RIVERS RD, SUITE 24-A, BASALT, CO 81621(970) 927-3143 Get Directions Write a Review

NPPES record last updated: February 6, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Extreme Sports Camp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXTREME SPORTS CAMP (NPI 1669744637) is a healthcare organization registered as a counselor in Basalt, Colorado and active in the NPI registry since February 2012. The organization lists Sallie Bernard, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1669744637
Entity TypeOrganization
Primary Taxonomy101Y00000X
Legal Business NameEXTREME SPORTS CAMP
Location Address23286 TWO RIVERS RD, SUITE 24-ABasalt, CO 81621-9285
Mailing Address23286 Two Rivers Rd, Suite 24-aBasalt, CO 81621-9285 · (970) 927-3143
Phone(970) 927-3143
Organization SubpartNo
Authorized OfficialSallie BernardExecutive Director · (970) 927-0433
Enumeration DateFebruary 6, 2012
✔ NPI 1669744637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in CO · 1534517
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

23286 TWO RIVERS RD, Basalt, CO 81621
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Extreme Sports Camp's NPI number?

The NPI number for Extreme Sports Camp is 1669744637. It was assigned to this organization in the NPPES registry on February 6, 2012.

Where is Extreme Sports Camp located?

Extreme Sports Camp is located at 23286 Two Rivers Rd Suite 24-A, Basalt, CO 81621. The listed phone number is (970) 927-3143.

What is Extreme Sports Camp's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Extreme Sports Camp was last updated on February 6, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.