Healthcare Provider Details

I. General information

NPI: 1508783358
Provider Name (Legal Business Name): BEA GIFFIN LCSW
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 N GARFIELD AVE STE 1
LOVELAND CO
80538-2246
US

IV. Provider business mailing address

4190 N GARFIELD AVE STE 1
LOVELAND CO
80538-2246
US

V. Phone/Fax

Practice location:
  • Phone: 970-235-0171
  • Fax:
Mailing address:
  • Phone: 970-235-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933328
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: