Active NPI
Daniel Hettleman, PH.D.
- Clinical Child & Adolescent Psychologist
- Denver, CO
National Provider Identifier
1912267246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 2399
- Practice address
- 1115 Grant St
#204
Denver, CO 80203-2369 - Phone
- (303) 912-6632
- NPI assigned
- May 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 2399 | CO | Primary |
Addresses
Primary practice location
1115 Grant St
#204
Denver, CO 80203-2369
Mailing address
1115 Grant St
#204
Denver, CO 80203-2369
Phone (303) 912-6632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2399 | CO | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337558400000",
"number": "1912267246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 GRANT ST",
"address_2": "#204",
"city": "DENVER",
"state": "CO",
"postal_code": "802032369",
"telephone_number": "303-912-6632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 GRANT ST",
"address_2": "#204",
"city": "DENVER",
"state": "CO",
"postal_code": "802032369",
"telephone_number": "303-912-6632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETTLEMAN",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-21",
"last_updated": "2012-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CO",
"license": "2399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.