Healthcare Provider Details

I. General information

NPI: 1487497830
Provider Name (Legal Business Name): DAVID STEVENS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 S MADISON ST STE 222
DENVER CO
80209-3013
US

IV. Provider business mailing address

155 S MADISON ST STE 222
DENVER CO
80209-3013
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-7702
  • Fax:
Mailing address:
  • Phone: 303-321-7702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number1113
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1113
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1113
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: