Provider Demographics
NPI:1053942748
Name:BALDWIN, BRYCE ANDERS
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:ANDERS
Last Name:BALDWIN
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 1:966 PLUM CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4384
Mailing Address - Country:US
Mailing Address - Phone:720-362-9192
Mailing Address - Fax:
Practice Address - Street 1:966 PLUM CREEK CT
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4384
Practice Address - Country:US
Practice Address - Phone:720-362-9192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0002083101YA0400X
COLPC.0020691101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)