Provider Demographics
NPI:1326927104
Name:BACKER, SAMUEL MAX
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:MAX
Last Name:BACKER
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 1:1901 N GRANT ST APT 1226
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1591
Mailing Address - Country:US
Mailing Address - Phone:925-300-6320
Mailing Address - Fax:
Practice Address - Street 1:1600 BROADWAY STE 1600
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-4916
Practice Address - Country:US
Practice Address - Phone:303-529-4602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical