Healthcare Provider Details

I. General information

NPI: 1295430783
Provider Name (Legal Business Name): JULIA RISKO KUTTLER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 S COLORADO BLVD PH NORTH
DENVER CO
80246-1904
US

IV. Provider business mailing address

720 S COLORADO BLVD PH NORTH
DENVER CO
80246-1904
US

V. Phone/Fax

Practice location:
  • Phone: 415-424-4266
  • Fax: 415-520-6633
Mailing address:
  • Phone: 415-424-4266
  • Fax: 415-520-6633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09928642
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: