Healthcare Provider Details

I. General information

NPI: 1902450398
Provider Name (Legal Business Name): ALYSSA HETSCHEL LCSW, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 W OXFORD AVE UNIT G-1
DENVER CO
80236-3112
US

IV. Provider business mailing address

3525 W OXFORD AVE UNIT G-2
DENVER CO
80236-3114
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-6150
  • Fax: 720-259-4559
Mailing address:
  • Phone: 303-315-0376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0000780
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09924651
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: