Provider Demographics
NPI:1972052975
Name:NAVARA, VINCENT
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:NAVARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S CLARKSON ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-1625
Mailing Address - Country:US
Mailing Address - Phone:303-317-7636
Mailing Address - Fax:
Practice Address - Street 1:1221 S CLARKSON ST
Practice Address - Street 2:SUITE 218
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-1625
Practice Address - Country:US
Practice Address - Phone:303-317-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health