Healthcare Provider Details

I. General information

NPI: 1144864182
Provider Name (Legal Business Name): MARC HEUSER LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2019
Last Update Date: 11/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 CHEYENNE ST
GOLDEN CO
80401-1127
US

IV. Provider business mailing address

7122 MARSHALL ST
ARVADA CO
80003-3600
US

V. Phone/Fax

Practice location:
  • Phone: 720-583-0922
  • Fax:
Mailing address:
  • Phone: 206-920-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPCC.0016376
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: