Provider Demographics
NPI:1114233434
Name:HAFEN, CHARMAYNE (MA, NCC)
Entity Type:Individual
Prefix:
First Name:CHARMAYNE
Middle Name:
Last Name:HAFEN
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 BROADWAY STE 2Q
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-2918
Mailing Address - Country:US
Mailing Address - Phone:720-272-8279
Mailing Address - Fax:
Practice Address - Street 1:7100 BROADWAY STE 2Q
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-2918
Practice Address - Country:US
Practice Address - Phone:720-272-8279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11853101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor