Healthcare Provider Details

I. General information

NPI: 1548946627
Provider Name (Legal Business Name): NATHAN ALEXANDER BEATY PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 S BELLAIRE ST STE 390
DENVER CO
80222-4350
US

IV. Provider business mailing address

5470 WATER TOWER PROMENADE APT 211
ARVADA CO
80002-3679
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-4244
  • Fax: 720-441-0448
Mailing address:
  • Phone: 269-921-2509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0006907
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: