MEDICARE: DR. MONTFORT O HASZ PSYD

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	103TC0700X	Clinical Psychologist	1818	CO

General Provider Information

NPI Number	:	1962525386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONTFORT O HASZ PSYD

Provider Business Mailing Address
First Line	:	8301 E PRENTICE AVE STE 300
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2906
Country	:	US
Telephone Number	:	720-489-8555
Fax Number	:	720-489-8304

Provider Business Practice Location Address
First Line	:	8301 E PRENTICE AVE STE 105
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2903
Country	:	US
Telephone Number	:	720-489-8555
Fax Number	:	720-489-8304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	01/28/2025

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