Healthcare Provider Details

I. General information

NPI: 1326286592
Provider Name (Legal Business Name): MILE HIGH BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 E. HAMPDEN AVE SUITE 108
DENVER CO
80231-4950
US

IV. Provider business mailing address

8801 E. HAMPDEN AVE SUITE 108
DENVER CO
80231-4950
US

V. Phone/Fax

Practice location:
  • Phone: 303-960-6249
  • Fax: 303-537-6923
Mailing address:
  • Phone: 303-960-6249
  • Fax: 303-537-6923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN JAMES BERT
Title or Position: OWNER/CFO/CLINICIAN
Credential: LCSW, CACIII
Phone: 303-960-6249