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NPI Code Detail

MEDICARE: MASAYO IWATE LCSW

MEDICARE: MASAYO IWATE LCSW
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 Worker992645CO

General Provider Information

NPI Number : 1275734899
Entity Type Code : Individual
Provider Name (Legal Business Name) : MASAYO IWATE LCSW
Provider Business Mailing Address
First Line : 1537 ALTON ST
Second Line :
City : AURORA
State : CO
Zip : 80010-1712
Country : US
Telephone Number : 303-923-2920
Fax Number :
Provider Business Practice Location Address
First Line : 1537 ALTON ST
Second Line :
City : AURORA
State : CO
Zip : 80010-1712
Country : US
Telephone Number : 303-923-2920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 10/28/2019

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Directions to “ MASAYO IWATE LCSW” Practice Location

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