MEDICARE: PROVIDENCE NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1033978853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROVIDENCE NETWORK

Provider Business Mailing Address
First Line	:	801 N LOGAN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3114
Country	:	US
Telephone Number	:	303-744-3986
Fax Number	:

Provider Business Practice Location Address
First Line	:	2514 CHAMPA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-2643
Country	:	US
Telephone Number	:	303-744-3986
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DEREK KUYKENDALL
Credential	:
Telephone Number	:	303-860-8484

Provider Enumeration Date	:	03/14/2024
Last Update Date	:	03/14/2024

Similar Medicare Providers

1447485628 — PARADISE, LLC.
Practice Location Address:

10691 E BETHANY DR
DENVER, CO
80014-2643

Practice Phone: 720-220-1377
Practice Fax:

1053654871 — LEAH ASQUITH
Practice Location Address:

3550 S KENDALL ST , 9-204
DENVER, CO
80235-2643

Practice Phone: 720-345-3229
Practice Fax:

1316588874 — VIVIANA C VETHENCOURT LPC
Practice Location Address:

1345 IVY ST
DENVER, CO
80220-2643

Practice Phone: 954-534-6744
Practice Fax:

1457013021 — KATHARINE ANNE WOODS NP
Practice Location Address:

2055 N HIGH ST STE 340
DENVER, CO
80205-5545

Practice Phone: 303-832-2344
Practice Fax: 303-832-3721

1598620270 — ILANA ARIEL KRAUSHAR RD
Practice Location Address:

1715 E 29TH AVE
DENVER, CO
80205-4504

Practice Phone: 561-379-4055
Practice Fax:

1932598679 — MR. JAMES EDWARD NEE HUNDLEY LCSW
Practice Location Address:

2253 N DOWNING ST
DENVER, CO
80205-5234

Practice Phone: 303-395-9748
Practice Fax:

Directions to “PROVIDENCE NETWORK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.