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NPI Code Detail

MEDICARE: NOAH DOHM LCSW, LAC

MEDICARE: NOAH DOHM LCSW, LAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW.09931200CO
2101YA0400XAddiction (Substance Use Disorder) CounselorACD.0002575CO

General Provider Information

NPI Number : 1265121057
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOAH DOHM LCSW, LAC
Provider Business Mailing Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-6500
Fax Number :
Provider Business Practice Location Address
First Line : 4455 E 12TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2415
Country : US
Telephone Number : 303-504-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2023
Last Update Date : 03/02/2026

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