Healthcare Provider Details

I. General information

NPI: 1861936064
Provider Name (Legal Business Name): PAUL ALLEN BRETZ D.MIN., LCSW, MHSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2016
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7887 EAST BELLEVIEW AVENUE SUITE 1100
DENVER CO
80111-6097
US

IV. Provider business mailing address

7887 EAST BELLEVIEW AVENUE SUITE 1100
DENVER CO
80111-6097
US

V. Phone/Fax

Practice location:
  • Phone: 303-639-5240
  • Fax:
Mailing address:
  • Phone: 303-639-5240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.00991917
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00991917
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: