Provider Demographics
NPI:1669969309
Name:GEORGE, WILLIAM EDWARD
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EDWARD
Last Name:GEORGE
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 1:13022 NIAGARA WAY
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-7940
Mailing Address - Country:US
Mailing Address - Phone:970-371-2220
Mailing Address - Fax:
Practice Address - Street 1:1850 RACE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1116
Practice Address - Country:US
Practice Address - Phone:303-209-5115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)