Provider Demographics
NPI:1508114265
Name:BRUGMAN, STUART THEODORE
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:THEODORE
Last Name:BRUGMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1840
Mailing Address - Country:US
Mailing Address - Phone:917-541-2541
Mailing Address - Fax:
Practice Address - Street 1:195 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1840
Practice Address - Country:US
Practice Address - Phone:917-541-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health