Healthcare Provider Details

I. General information

NPI: 1780556217
Provider Name (Legal Business Name): ANDREW SCOTT HOBON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 S VINE ST # 1300
CENTENNIAL CO
80122-3171
US

IV. Provider business mailing address

6767 S VINE ST # 1300
CENTENNIAL CO
80122-3171
US

V. Phone/Fax

Practice location:
  • Phone: 469-892-8483
  • Fax:
Mailing address:
  • Phone: 469-892-8483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09932320
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: