Healthcare Provider Details

I. General information

NPI: 1124837554
Provider Name (Legal Business Name): AUTISM BEHAVIORAL VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 NAVAJO ST
DENVER CO
80211-2440
US

IV. Provider business mailing address

PO BOX 258831
OKLAHOMA CITY OK
73125-8831
US

V. Phone/Fax

Practice location:
  • Phone: 720-961-3764
  • Fax:
Mailing address:
  • Phone: 775-560-3345
  • Fax: 775-560-3345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN MUELLER
Title or Position: OWNER
Credential:
Phone: 775-560-3345