Provider Demographics
NPI:1790029841
Name:ALLEN, PAUL DEAN
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DEAN
Last Name:ALLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:DEAN
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:5040 SADDLEBACK HTS
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-1118
Mailing Address - Country:US
Mailing Address - Phone:719-231-4715
Mailing Address - Fax:
Practice Address - Street 1:5525 N. MACARTHUR BLVD, SUITE 800
Practice Address - Street 2:MHN GOVERNMENT SERVICES
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038
Practice Address - Country:US
Practice Address - Phone:972-550-4598
Practice Address - Fax:972-550-2584
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2424101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional