Provider Demographics
NPI:1104973379
Name:CHASE, EDWARD RAY (LPC)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:RAY
Last Name:CHASE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8933 E UNION AVE STE 2950
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1354
Mailing Address - Country:US
Mailing Address - Phone:303-263-3305
Mailing Address - Fax:303-220-7899
Practice Address - Street 1:8933 E UNION AVE STE 2950
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1354
Practice Address - Country:US
Practice Address - Phone:303-263-3305
Practice Address - Fax:303-220-7899
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1965101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor