Healthcare Provider Details

I. General information

NPI: 1356306955
Provider Name (Legal Business Name): SUSAN LEE BENSON DNP, FNP, PMH-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7114 CEDARWOOD CIR
BOULDER CO
80301-3701
US

IV. Provider business mailing address

7114 CEDARWOOD CIR
BOULDER CO
80301-3701
US

V. Phone/Fax

Practice location:
  • Phone: 303-990-1930
  • Fax: 303-569-7423
Mailing address:
  • Phone: 303-990-1930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number177793
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number177793
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: