OrganizationActive
Extreme Sports Camp
NPI 1669744637 · Counselor · Basalt, CO
Provider details
- NPI number
- 1669744637
- Entity type
- Organization
- Primary specialty
- CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Sallie Bernard, Executive Director(970) 927-0433
- License
- 1534517 (CO)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
23286 Two Rivers Rd
Suite 24-A
Basalt, CO 81621-9285
Phone: (970) 927-3143
Street-level locationGet directions
Mailing address
23286 Two Rivers Rd
Basalt, CO 81621-9285
Registry dates
- Enumerated
- 2012-02-06
- Last updated
- 2012-02-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.