Healthcare Provider Details

I. General information

NPI: 1063936961
Provider Name (Legal Business Name): HOLLY ANN BRETTELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S ALBION ST STE 515
DENVER CO
80222-4043
US

IV. Provider business mailing address

2420 S OSCEOLA ST
DENVER CO
80219-5208
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-9617
  • Fax: 303-578-9617
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number.0009924794
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: