Healthcare Provider Details

I. General information

NPI: 1639875214
Provider Name (Legal Business Name): AUTISM WEST BEHAVIORAL PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11674 HURON ST STE 150
NORTHGLENN CO
80234-4000
US

IV. Provider business mailing address

700 COLORADO BLVD # 703
DENVER CO
80206-4084
US

V. Phone/Fax

Practice location:
  • Phone: 720-634-9500
  • Fax:
Mailing address:
  • Phone: 720-634-9502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: JENNY WEBB
Title or Position: OFFICE MANAGER
Credential:
Phone: 720-634-9500