Provider Demographics
NPI:1487497830
Name:STEVENS, DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:STEVENS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S MADISON ST STE 222
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3013
Mailing Address - Country:US
Mailing Address - Phone:303-321-7702
Mailing Address - Fax:
Practice Address - Street 1:155 S MADISON ST STE 222
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3013
Practice Address - Country:US
Practice Address - Phone:303-321-7702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1113102L00000X, 103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist