MEDICARE: AUTISM WEST BEHAVIORAL PARTNERS, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	101YP2500X	Professional Counselor
3	106S00000X	Behavior Technician
4	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1639875214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUTISM WEST BEHAVIORAL PARTNERS, INC

Provider Business Mailing Address
First Line	:	700 COLORADO BLVD # 703
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-4084
Country	:	US
Telephone Number	:	720-634-9502
Fax Number	:

Provider Business Practice Location Address
First Line	:	11674 HURON ST STE 150
Second Line	:
City	:	NORTHGLENN
State	:	CO
Zip	:	80234-4000
Country	:	US
Telephone Number	:	720-634-9500
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JENNY WEBB
Credential	:
Telephone Number	:	720-634-9500

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	04/21/2023

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