Provider Demographics
NPI:1912446329
Name:ARAGON, BENJAMIN ABEDON JR (CAC III)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ABEDON
Last Name:ARAGON
Suffix:JR
Gender:M
Credentials:CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4485 WADSWORTH BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3310
Mailing Address - Country:US
Mailing Address - Phone:303-431-5664
Mailing Address - Fax:303-431-6713
Practice Address - Street 1:4485 WADSWORTH BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3310
Practice Address - Country:US
Practice Address - Phone:303-431-5664
Practice Address - Fax:303-431-6713
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC0002526101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)