Healthcare Provider Details

I. General information

NPI: 1346070398
Provider Name (Legal Business Name): ETHAN ASHER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 LEETSDALE DR STE 300
DENVER CO
80246-1451
US

IV. Provider business mailing address

PO BOX 18412
PALATINE IL
60055-8412
US

V. Phone/Fax

Practice location:
  • Phone: 303-393-8050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0024723
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: