MEDICARE: JACQUELYN STANTON L.C.S.W.

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
1	1041C0700X	Clinical Social Worker	989076	CO

General Provider Information

NPI Number	:	1730621061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELYN STANTON L.C.S.W.

Provider Business Mailing Address
First Line	:	14991 E 50TH DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-4282
Country	:	US
Telephone Number	:	720-402-9448
Fax Number	:

Provider Business Practice Location Address
First Line	:	14991 E 50TH DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-4282
Country	:	US
Telephone Number	:	720-402-9448
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2016
Last Update Date	:	01/13/2026

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