Healthcare Provider Details

I. General information

NPI: 1043987118
Provider Name (Legal Business Name): SOLLITA LUCERO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S ABILENE ST
AURORA CO
80014-2322
US

IV. Provider business mailing address

7887 E BELLEVIEW AVE
ENGLEWOOD CO
80111-6015
US

V. Phone/Fax

Practice location:
  • Phone: 720-645-9817
  • Fax:
Mailing address:
  • Phone: 303-639-5240
  • Fax: 303-639-5243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09927451
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: