Provider Demographics
NPI:1639607336
Name:REINE EVERETEZE, PSYD, LLC
Entity Type:Organization
Organization Name:REINE EVERETEZE, PSYD, LLC
Other - Org Name:REINE EVERETEZE, PSY.D., LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:REINE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERETEZE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-931-7137
Mailing Address - Street 1:8015 W ALAMEDA AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3076
Mailing Address - Country:US
Mailing Address - Phone:303-202-6143
Mailing Address - Fax:303-202-6146
Practice Address - Street 1:8015 W ALAMEDA AVE STE 230
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3076
Practice Address - Country:US
Practice Address - Phone:303-202-6143
Practice Address - Fax:303-202-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-25
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty