Healthcare Provider Details

I. General information

NPI: 1982178802
Provider Name (Legal Business Name): AIMEE ALCORN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 YORK ST
DENVER CO
80206-1410
US

IV. Provider business mailing address

16349 E RADCLIFF PL APT A
AURORA CO
80015-7116
US

V. Phone/Fax

Practice location:
  • Phone: 303-935-5307
  • Fax:
Mailing address:
  • Phone: 303-437-7819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09925807
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: