Provider Demographics
NPI:1700226479
Name:PROCTER, WILLIAM ALEXANDER (MS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ALEXANDER
Last Name:PROCTER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 E GIRARD PL
Mailing Address - Street 2:328A
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-9233
Mailing Address - Country:US
Mailing Address - Phone:703-863-7578
Mailing Address - Fax:
Practice Address - Street 1:2460 S VINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80208-0001
Practice Address - Country:US
Practice Address - Phone:303-871-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health