Provider Demographics
NPI:1164010518
Name:WIDENER, HIRAM EMORY III (LPCC)
Entity Type:Individual
Prefix:
First Name:HIRAM
Middle Name:EMORY
Last Name:WIDENER
Suffix:III
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3032
Mailing Address - Street 2:
Mailing Address - City:SILVERTHORNE
Mailing Address - State:CO
Mailing Address - Zip Code:80498-3032
Mailing Address - Country:US
Mailing Address - Phone:303-515-1722
Mailing Address - Fax:
Practice Address - Street 1:3000 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-3414
Practice Address - Country:US
Practice Address - Phone:303-578-9434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0017045101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty