Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | NLC.0106175 | CO |
Y | 1041C0700X | Clinical Social Worker | CSW.09925690 | CO |
NPI | 1003342379 |
---|---|
Provider Name | Anna Joseph |
First Address | Aurora, CO 80011-8736 |
Second Address | Aurora, CO 80011-8736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2017 |
Last Update Date | 02/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CSW.09925690 | COLORADO LICENSED CLINICAL SOCIAL WORKER NUMBER (01) | CO |
NLC.0106175 | COLORADO REGISTERED PSYCHOTHERAPIST NUMBER (01) | CO |