Healthcare Provider Details

I. General information

NPI: 1144763939
Provider Name (Legal Business Name): STEVEN SPATZ COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 38TH STREET SUITE 100E
BOULDER CO
80301
US

IV. Provider business mailing address

PO BOX 1903
BOULDER CO
80306-1903
US

V. Phone/Fax

Practice location:
  • Phone: 703-677-2688
  • Fax: 703-635-7296
Mailing address:
  • Phone: 703-677-2688
  • Fax: 703-635-7296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0701006164
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: STEVEN H SPATZ
Title or Position: LICENSED PROFESSIONAL COUNSELOR AND
Credential: LPC
Phone: 703-677-2688