=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386453934
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AUTISM WEST BEHAVIORAL PARTNERS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2025
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3489 W 72ND AVE STE 230
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80030-5314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-634-9500
-----------------------------------------------------
Fax | 877-599-0808
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10730 E BETHANY DR STE 355
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80014-2806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | JENNY WEBB
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-400-4579
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------