Provider Demographics
NPI:1386702322
Name:BERENZ, AMBER R (MA)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:R
Last Name:BERENZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5984 S PRINCE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2083
Mailing Address - Country:US
Mailing Address - Phone:303-749-4706
Mailing Address - Fax:
Practice Address - Street 1:5984 S PRINCE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2083
Practice Address - Country:US
Practice Address - Phone:303-749-4706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4188101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional