Healthcare Provider Details

I. General information

NPI: 1801200084
Provider Name (Legal Business Name): DANIELLE PETERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 E GIRARD AVE STE 3100
AURORA CO
80014-5002
US

IV. Provider business mailing address

9324 E 58TH DR
DENVER CO
80238-2370
US

V. Phone/Fax

Practice location:
  • Phone: 571-643-6170
  • Fax:
Mailing address:
  • Phone: 720-807-2851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09924446
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: