Healthcare Provider Details

I. General information

NPI: 1558180596
Provider Name (Legal Business Name): BUH SPOK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 S SYRACUSE WAY STE 260
GREENWOOD VILLAGE CO
80111-4739
US

IV. Provider business mailing address

6200 S SYRACUSE WAY STE 260
GREENWOOD VILLAGE CO
80111-4739
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-0581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KEDRI LADEWIG
Title or Position: FOUNDER/THERAPIST
Credential: LCSW
Phone: 720-515-0581