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General NPI Number Information
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NPI Number | 1568813137
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Entity Type | Individual
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Provider Name | BRIEN BENJAMIN M.A.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 175 PHEASANT RUN
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City | LOUISVILLE
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State | CO
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Zip | 80027-4304
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Country | US
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Telephone | 808-666-1054
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Fax |
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Provider Business Mailing Address
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Address Line | 175 PHEASANT RUN
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City | LOUISVILLE
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State | CO
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Zip | 80027-4304
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Country | US
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Telephone | 808-666-1054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | NLC0010525
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.0023152
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License Number State | CO
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