Healthcare Provider Details

I. General information

NPI: 1578389144
Provider Name (Legal Business Name): SOCIAL CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2024
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9615 E COUNTY LINE RD STE B-525
CENTENNIAL CO
80112-3527
US

IV. Provider business mailing address

9615 E COUNTY LINE RD STE B-525
CENTENNIAL CO
80112-3527
US

V. Phone/Fax

Practice location:
  • Phone: 904-294-5329
  • Fax: 172-072-2052
Mailing address:
  • Phone:
  • Fax: 172-072-2052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. HYDEE WARREN
Title or Position: CHIEF OPEATIONS OFFICER
Credential: LMHC
Phone: 904-294-5329