Healthcare Provider Details

I. General information

NPI: 1467525709
Provider Name (Legal Business Name): PETER MERRITT LEAR MSW LCSW, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 BROADWAY ST STE 309
BOULDER CO
80304-3173
US

IV. Provider business mailing address

4779 WHITE ROCK CIR APT C
BOULDER CO
80301-5366
US

V. Phone/Fax

Practice location:
  • Phone: 303-981-7227
  • Fax:
Mailing address:
  • Phone: 303-981-7227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.00001892
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: