Healthcare Provider Details

I. General information

NPI: 1235691254
Provider Name (Legal Business Name): ROXANNE DARLING TANICK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROXANNE DARLING CAFARO

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17581 PINE LN APT 4412
PARKER CO
80134-6547
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 720-722-4375
  • Fax:
Mailing address:
  • Phone: 970-624-4123
  • Fax: 970-624-2416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09924729
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: