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General NPI Number Information
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NPI Number | 1871411710
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Entity Type | Individual
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Provider Name | JONATHAN E DEFEZ
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Gender | Male
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Dates
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Enumeration Date | 07/08/2026
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Last Update Date | 07/08/2026
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Provider Practice Location Address
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Address Line | 5500 S SYCAMORE ST STE 100
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City | LITTLETON
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State | CO
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Zip | 80120-1132
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Country | US
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Telephone | 720-696-7562
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Fax |
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Provider Business Mailing Address
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Address Line | 5596 E. LEHIGH AVE N/A
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City | DENVER
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State | CO
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Zip | 80237
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Country | US
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Telephone | 303-917-3045
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | STU-0010866
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License Number State | CO
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