Provider Demographics
NPI:1033807169
Name:MANN, BENJAMIN EUGENE (MDIV, MPA)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:EUGENE
Last Name:MANN
Suffix:
Gender:M
Credentials:MDIV, MPA
Other - Prefix:
Other - First Name:BENJAMIN
Other - Middle Name:EUGENE
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MDIV, MPA
Mailing Address - Street 1:1665 AURORA CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2517
Mailing Address - Country:US
Mailing Address - Phone:720-848-4063
Mailing Address - Fax:
Practice Address - Street 1:1890 N REVERE CT STE 4003
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7464
Practice Address - Country:US
Practice Address - Phone:303-724-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health