Healthcare Provider Details

I. General information

NPI: 1063831071
Provider Name (Legal Business Name): CHRISTOPHER DUVERNAY M.A., LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 KING ST
DENVER CO
80219-1326
US

IV. Provider business mailing address

325 KING ST
DENVER CO
80219-1326
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-4100
  • Fax:
Mailing address:
  • Phone: 303-225-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6352
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: