Healthcare Provider Details

I. General information

NPI: 1497261473
Provider Name (Legal Business Name): JULIE CASPERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 09/12/2025
Certification Date: 11/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 E KEN PRATT BLVD
LONGMONT CO
80504-5311
US

IV. Provider business mailing address

1590 BRADLEY DR
BOULDER CO
80305-7377
US

V. Phone/Fax

Practice location:
  • Phone: 720-718-7000
  • Fax: 720-718-0900
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberISW12172
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09926817
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: