Healthcare Provider Details

I. General information

NPI: 1396022075
Provider Name (Legal Business Name): STEPHEN SBANOTTO MS, LPC, CSAT-S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2011
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 N LINCOLN ST APT 7F
DENVER CO
80203-2767
US

IV. Provider business mailing address

925 N LINCOLN ST APT 7F
DENVER CO
80203-2767
US

V. Phone/Fax

Practice location:
  • Phone: 720-319-7384
  • Fax:
Mailing address:
  • Phone: 720-319-7384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberNLC 0104553
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA1101005
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0013970
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: