Healthcare Provider Details

I. General information

NPI: 1063932358
Provider Name (Legal Business Name): BENJAMIN GAIBEL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 W 26TH AVE
DENVER CO
80211-5314
US

IV. Provider business mailing address

2490 W 26TH AVE
DENVER CO
80211-5314
US

V. Phone/Fax

Practice location:
  • Phone: 303-433-0620
  • Fax:
Mailing address:
  • Phone: 303-433-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.00001320
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: