Provider Demographics
NPI:1841548609
Name:BADWAN PSYCHOLOGY PLLC
Entity type:Organization
Organization Name:BADWAN PSYCHOLOGY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OUS
Authorized Official - Middle Name:H
Authorized Official - Last Name:BADWAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MFT
Authorized Official - Phone:312-493-9111
Mailing Address - Street 1:950 N LOGAN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3186
Mailing Address - Country:US
Mailing Address - Phone:303-834-1026
Mailing Address - Fax:877-358-4558
Practice Address - Street 1:950 N LOGAN ST STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3186
Practice Address - Country:US
Practice Address - Phone:303-834-1026
Practice Address - Fax:877-358-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO871106H00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty