Healthcare Provider Details

I. General information

NPI: 1053966564
Provider Name (Legal Business Name): PAUL DEUTSCH LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3836 YORK ST
DENVER CO
80205
US

IV. Provider business mailing address

3836 YORK ST ATTN: PAUL DEUTSCH
DENVER CO
80205
US

V. Phone/Fax

Practice location:
  • Phone: 303-656-3728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09924632
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: