Basic Information
Provider Information
NPI: 1528527793
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARON
FirstName: DAVID
MiddleName: MATTHEW
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4455 E 12TH AVE
Address2:  
City: DENVER
State: CO
PostalCode: 802202415
CountryCode: US
TelephoneNumber: 3035047941
FaxNumber: 3035047990
Practice Location
Address1: 4455 E 12TH AVE
Address2:  
City: DENVER
State: CO
PostalCode: 802202415
CountryCode: US
TelephoneNumber: 3035047941
FaxNumber: 3035047990
Other Information
ProviderEnumerationDate: 03/18/2019
LastUpdateDate: 05/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XCSW.09926587COY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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