Healthcare Provider Details

I. General information

NPI: 1740951086
Provider Name (Legal Business Name): BARTLEY JOSEPH ZUCOSKY III LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 09/27/2021
Certification Date: 09/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 LITTLE RAVEN ST APT 227
DENVER CO
80202-7167
US

IV. Provider business mailing address

1900 LITTLE RAVEN ST APT 227
DENVER CO
80202-7167
US

V. Phone/Fax

Practice location:
  • Phone: 908-499-1918
  • Fax:
Mailing address:
  • Phone: 908-499-1918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW.09927648
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: