Healthcare Provider Details

I. General information

NPI: 1518821453
Provider Name (Legal Business Name): HOSSEIN HASHEMINIASARI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20765 E FAIR PL
CENTENNIAL CO
80016-3805
US

IV. Provider business mailing address

20765 E FAIR PL
CENTENNIAL CO
80016-3805
US

V. Phone/Fax

Practice location:
  • Phone: 720-404-7717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: