Basic Information
| Provider Information | |||||||||
| NPI: | 1922140383 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEREN | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4355 BATAVIA PL | ||||||||
| Address2: | # 5 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802201060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033337823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8989 HURON ST | ||||||||
| Address2: | |||||||||
| City: | THORNTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802606858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038533500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFT 457 | CO | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.