Healthcare Provider Details

I. General information

NPI: 1720035215
Provider Name (Legal Business Name): KARLA BIBIANA VON MERZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 FEDERAL BLVD
DENVER CO
80204-2211
US

IV. Provider business mailing address

4141 E DICKENSON PL
DENVER CO
80222-6012
US

V. Phone/Fax

Practice location:
  • Phone: 303-504-1500
  • Fax: 303-825-1711
Mailing address:
  • Phone: 303-504-6509
  • Fax: 303-782-0916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number536
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: