Healthcare Provider Details

I. General information

NPI: 1619139896
Provider Name (Legal Business Name): WILLIAM COSTAS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8751 E HAMPDEN AVE STE B-3
DENVER CO
80231-4952
US

IV. Provider business mailing address

8751 E HAMPDEN AVE STE B-3
DENVER CO
80231-4952
US

V. Phone/Fax

Practice location:
  • Phone: 303-919-0000
  • Fax:
Mailing address:
  • Phone: 303-919-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number1301
License Number StateCO

VIII. Authorized Official

Name: DR. WILLIAM NICHOLAS COSTAS
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 303-919-0000