Healthcare Provider Details

I. General information

NPI: 1588095541
Provider Name (Legal Business Name): STACEY HOFFMAN HIATT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 08/18/2024
Certification Date: 08/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 LAWRENCE ST
DENVER CO
80205-2126
US

IV. Provider business mailing address

11224 QUIVAS LOOP
WESTMINSTER CO
80234-2615
US

V. Phone/Fax

Practice location:
  • Phone: 720-998-6276
  • Fax:
Mailing address:
  • Phone: 303-547-2313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00000698
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: