Healthcare Provider Details

I. General information

NPI: 1295922862
Provider Name (Legal Business Name): JUDITH ANN CHANDLER LCSW, CACIII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT STREET VA MEDICAL CENTER
DENVER CO
80220
US

IV. Provider business mailing address

1055 CLERMONT STREET VA MEDICAL CENTER
DENVER CO
80220
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-393-5076
Mailing address:
  • Phone: 303-399-8020
  • Fax: 303-393-5076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number988023
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: