Healthcare Provider Details

I. General information

NPI: 1063334746
Provider Name (Legal Business Name): EDC OF DENVER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 E MISSISSIPPI AVE STE 1300
DENVER CO
80246-3057
US

IV. Provider business mailing address

4100 E MISSISSIPPI AVE STE 1300
DENVER CO
80246-3057
US

V. Phone/Fax

Practice location:
  • Phone: 720-889-4235
  • Fax: 720-889-4258
Mailing address:
  • Phone: 720-889-4235
  • Fax: 720-889-4258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSIE LERNER
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 720-889-4235