Healthcare Provider Details

I. General information

NPI: 1467551325
Provider Name (Legal Business Name): KEVIN NEAL BEECHER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3263 FRASER ST SUITE 3
AURORA CO
80011-1217
US

IV. Provider business mailing address

3263 FRASER ST SUITE 3
AURORA CO
80011-1217
US

V. Phone/Fax

Practice location:
  • Phone: 303-371-1000
  • Fax: 303-371-1002
Mailing address:
  • Phone: 303-371-1000
  • Fax: 303-371-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-857
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-638
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW-09923201
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: