Healthcare Provider Details

I. General information

NPI: 1942111588
Provider Name (Legal Business Name): MARTIN NGWA CSWC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4159 LOWELL BLVD
DENVER CO
80211-1658
US

IV. Provider business mailing address

9535 W COAL MINE AVE APT E
LITTLETON CO
80123-4069
US

V. Phone/Fax

Practice location:
  • Phone: 303-318-1755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWC.0000000314
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: