Provider Demographics
NPI:1720419237
Name:GINSBERG, STEPHEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:GINSBERG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 GRANT ST
Mailing Address - Street 2:SUITE G-4
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2369
Mailing Address - Country:US
Mailing Address - Phone:720-432-4184
Mailing Address - Fax:
Practice Address - Street 1:1115 GRANT ST
Practice Address - Street 2:SUITE G-4
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2369
Practice Address - Country:US
Practice Address - Phone:720-432-4184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3799103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical