Healthcare Provider Details

I. General information

NPI: 1730567405
Provider Name (Legal Business Name): MEREDITH SUZANNE VELASQUEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEREDITH SUZANNE SLOCUM MSW

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6766 S REVERE PKWY STE 100
CENTENNIAL CO
80112-6774
US

IV. Provider business mailing address

6766 S REVERE PKWY STE 100
CENTENNIAL CO
80112-6774
US

V. Phone/Fax

Practice location:
  • Phone: 720-213-1320
  • Fax:
Mailing address:
  • Phone: 720-213-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9924853
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number897
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: