Healthcare Provider Details

I. General information

NPI: 1407546609
Provider Name (Legal Business Name): MARK D SEARLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N GRANT ST STE N
DENVER CO
80203-1859
US

IV. Provider business mailing address

1500 N GRANT ST STE N
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 719-315-9544
  • Fax:
Mailing address:
  • Phone: 719-315-9544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWC.0000000709
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: