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NPI Code Detail

MEDICARE: DEVIN DENISON CSW

MEDICARE:   DEVIN  DENISON  CSW
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 WorkerLCSW-1684WY
21041C0700XClinical Social WorkerCSW.09930675CO

General Provider Information

NPI Number : 1760154736
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVIN DENISON CSW
Provider Business Mailing Address
First Line : PO BOX 20092
Second Line :
City : CHEYENNE
State : WY
Zip : 82003-7002
Country : US
Telephone Number : 307-630-4729
Fax Number :
Provider Business Practice Location Address
First Line : 1301 RIVERSIDE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4374
Country : US
Telephone Number : 970-888-4070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2021
Last Update Date : 07/20/2024

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