Healthcare Provider Details

I. General information

NPI: 1811564818
Provider Name (Legal Business Name): CATHERINE BRIANA MOXLEY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE SIMPSON

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 W 6TH AVE STE 140
LAKEWOOD CO
80215-5588
US

IV. Provider business mailing address

4851 INDEPENDENCE ST
WHEAT RIDGE CO
80033-6715
US

V. Phone/Fax

Practice location:
  • Phone: 720-756-0138
  • Fax:
Mailing address:
  • Phone: 303-425-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09929551
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: