Healthcare Provider Details

I. General information

NPI: 1326043183
Provider Name (Legal Business Name): WILLIAM G SEMPLE MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 FLORAL DR
BOULDER CO
80304-2738
US

IV. Provider business mailing address

2030 FLORAL DR
BOULDER CO
80304-2738
US

V. Phone/Fax

Practice location:
  • Phone: 303-449-1669
  • Fax: 720-306-3263
Mailing address:
  • Phone: 303-449-1669
  • Fax: 720-306-3263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number989070
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: