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NPI Code Detail

MEDICARE: JILL DAISS-LUCAS LCSW

MEDICARE: JILL DAISS-LUCAS 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 WorkerCSW.09925130CO

General Provider Information

NPI Number : 1881151272
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL DAISS-LUCAS LCSW
Provider Business Mailing Address
First Line : 12766 W 61ST PL
Second Line :
City : ARVADA
State : CO
Zip : 80004-3924
Country : US
Telephone Number : 303-204-9246
Fax Number :
Provider Business Practice Location Address
First Line : 5335 W 48TH AVE STE 500
Second Line :
City : DENVER
State : CO
Zip : 80212-2732
Country : US
Telephone Number : 720-288-0813
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2019
Last Update Date : 09/26/2024

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