Provider Demographics
NPI:1538619937
Name:MATSON, JAMES ALAN (MA, LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALAN
Last Name:MATSON
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E SPEER BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3719
Mailing Address - Country:US
Mailing Address - Phone:720-507-8910
Mailing Address - Fax:
Practice Address - Street 1:825 E SPEER BLVD STE 220
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3719
Practice Address - Country:US
Practice Address - Phone:720-507-8910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014704101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1538619937Medicaid