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NPI Code Detail

MEDICARE: NICHOLAS BAER HERZOG

MEDICARE:   NICHOLAS BAER HERZOG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorOR

General Provider Information

NPI Number : 1558918250
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS BAER HERZOG
Provider Business Mailing Address
First Line : 5350 S ROSLYN ST STE 240
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2123
Country : US
Telephone Number : 503-352-7333
Fax Number :
Provider Business Practice Location Address
First Line : 5350 S ROSLYN ST STE 240
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2123
Country : US
Telephone Number : 303-351-2445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2019
Last Update Date : 07/12/2025

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Directions to “ NICHOLAS BAER HERZOG ” Practice Location

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