Provider Demographics
NPI:1407867716
Name:BOBER, STEPHEN D (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:BOBER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8795 RALSTON RD STE 126
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2320
Mailing Address - Country:US
Mailing Address - Phone:303-456-0611
Mailing Address - Fax:
Practice Address - Street 1:8795 RALSTON RD STE 126
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2320
Practice Address - Country:US
Practice Address - Phone:303-456-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7106388Medicaid
CO7106388Medicaid
COC94946Medicare PIN