Provider Demographics
NPI:1932116522
Name:PETERSON, DEAN ERIC (MA, LPC, CAC III)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:ERIC
Last Name:PETERSON
Suffix:
Gender:M
Credentials:MA, LPC, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10560 W ALAMO PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-2039
Mailing Address - Country:US
Mailing Address - Phone:303-877-7798
Mailing Address - Fax:
Practice Address - Street 1:7114 W JEFFERSON AVE
Practice Address - Street 2:#111
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2354
Practice Address - Country:US
Practice Address - Phone:303-877-7798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5507101YA0400X
CO2174101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)