Provider Demographics
NPI:1699211722
Name:PEROZO TREJO, BERYIMAR H (CAS NLP)
Entity Type:Individual
Prefix:
First Name:BERYIMAR
Middle Name:H
Last Name:PEROZO TREJO
Suffix:
Gender:F
Credentials:CAS NLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 LELAND PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-1637
Mailing Address - Country:US
Mailing Address - Phone:720-933-5161
Mailing Address - Fax:
Practice Address - Street 1:1155 CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204
Practice Address - Country:US
Practice Address - Phone:303-436-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0020891101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)