Provider Demographics
NPI:1508193939
Name:DIMOS, JONATHAN K (PHD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:K
Last Name:DIMOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W DAVIES AVE N
Mailing Address - Street 2:STE 105
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5211
Mailing Address - Country:US
Mailing Address - Phone:303-730-1717
Mailing Address - Fax:303-730-1531
Practice Address - Street 1:141 W DAVIES AVE N
Practice Address - Street 2:STE 105
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120
Practice Address - Country:US
Practice Address - Phone:303-730-1717
Practice Address - Fax:303-730-1531
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004461103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling