Provider Demographics
NPI:1669050720
Name:MAGETTE, AUSTIN LOUIS
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:LOUIS
Last Name:MAGETTE
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 1:2501 DALLAS ST STE 274
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-1043
Mailing Address - Country:US
Mailing Address - Phone:720-459-6451
Mailing Address - Fax:
Practice Address - Street 1:2501 DALLAS ST STE 274
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-1043
Practice Address - Country:US
Practice Address - Phone:720-608-0379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 171M00000X
CO1669050720106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator