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NPI Code Detail

MEDICARE: JEFFREY HOLLIDAY LCSW

MEDICARE: JEFFREY HOLLIDAY 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
1101YM0800XMental Health CounselorCSW-992266CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285753715
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY HOLLIDAY LCSW
Provider Business Mailing Address
First Line : 1290 S POTOMAC ST
Second Line :
City : AURORA
State : CO
Zip : 80012-4524
Country : US
Telephone Number : 303-745-1281
Fax Number : 303-671-2854
Provider Business Practice Location Address
First Line : 1290 S POTOMAC ST
Second Line :
City : AURORA
State : CO
Zip : 80012-4524
Country : US
Telephone Number : 303-745-1281
Fax Number : 303-671-2854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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Directions to “ JEFFREY HOLLIDAY LCSW” Practice Location

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