Healthcare Provider Details

I. General information

NPI: 1356010201
Provider Name (Legal Business Name): NATALIE SLACK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5125 S KIPLING PKWY STE 340
LITTLETON CO
80127-1736
US

IV. Provider business mailing address

4045 W 41ST AVE
DENVER CO
80212-2139
US

V. Phone/Fax

Practice location:
  • Phone: 203-383-0825
  • Fax:
Mailing address:
  • Phone: 203-383-0825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933227
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: