Provider Demographics
NPI:1487806972
Name:BEVERLY A. BRAUER, PSYD, INC.
Entity type:Organization
Organization Name:BEVERLY A. BRAUER, PSYD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-754-7086
Mailing Address - Street 1:12101 E 2ND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8328
Mailing Address - Country:US
Mailing Address - Phone:303-754-7086
Mailing Address - Fax:303-695-6925
Practice Address - Street 1:12101 E 2ND AVE STE 110
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8328
Practice Address - Country:US
Practice Address - Phone:303-754-7086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1316103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COB4207Medicare PIN