Provider Demographics
NPI:1962525386
Name:HASZ, MONTFORT O (PSYD)
Entity type:Individual
Prefix:DR
First Name:MONTFORT
Middle Name:O
Last Name:HASZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 E PRENTICE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2906
Mailing Address - Country:US
Mailing Address - Phone:720-489-8555
Mailing Address - Fax:720-489-8304
Practice Address - Street 1:8301 E PRENTICE AVE STE 105
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2903
Practice Address - Country:US
Practice Address - Phone:720-489-8555
Practice Address - Fax:720-489-8304
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1818103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCA3736Medicare UPIN