Ralph S. Datema, D MIN.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

105 Issued in CO

Practice address

1564 Senter Ave
Burlington, CO 80807-1645

Phone

(303) 974-0947

NPI assigned

May 15, 2007

Last updated

Aug 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1073729828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 WARD RD UNIT 212",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800043822",
            "telephone_number": "303-974-0947",
            "fax_number": "720-242-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1564 SENTER AVE",
            "city": "BURLINGTON",
            "state": "CO",
            "postal_code": "808071645",
            "telephone_number": "303-974-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATEMA",
        "first_name": "RALPH",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D MIN.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "105",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NE",
            "license": "1441 76",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamera Cooper
• County of Kit Carson (Kit Carson County Ambulance)
• County of Kit Carson (Kit Carson County Ambulance Service)
• Tammy Crites, RN
• Denise Dawn Cure, RN
• Krista Shalynn Davis, LCSW
• Denver Vamc
• Jenna Deubler
• Kathryn Helen Dobler, RN, BSN
• Susan Marie Dorman, RN, CS-FNP

• Marriage & Family Therapist in Burlington, CO
• Providers in Burlington, CO by specialty
• Marriage & Family Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.