Healthcare Provider Details

I. General information

NPI: 1447754304
Provider Name (Legal Business Name): BRANDON HOLLINGSWORTH PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 E EVANS AVE
DENVER CO
80222-5406
US

IV. Provider business mailing address

3857 MALLARD ST
HIGHLANDS RANCH CO
80126-2937
US

V. Phone/Fax

Practice location:
  • Phone: 720-640-4567
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number37685
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number37685
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0005881
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: