Provider Demographics
NPI:1326746025
Name:BADWAN PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:BADWAN PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OUS
Authorized Official - Middle Name:HUSSEIN
Authorized Official - Last Name:BADWAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-834-1026
Mailing Address - Street 1:6881 S HOLLY CIR STE 205
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1145
Mailing Address - Country:US
Mailing Address - Phone:303-834-1026
Mailing Address - Fax:877-358-4558
Practice Address - Street 1:6881 S HOLLY CIR STE 205
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1145
Practice Address - Country:US
Practice Address - Phone:303-834-1026
Practice Address - Fax:877-358-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82288241Medicaid