Healthcare Provider Details

I. General information

NPI: 1457595712
Provider Name (Legal Business Name): ALISA M HARNDEN MSW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISA M DEAN MSW LCSW

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 SOUTH LINCOLN AVE
STEAMBOAT SPRINGS CO
80487
US

IV. Provider business mailing address

715 HORIZON DR STE 225
GRAND JUNCTION CO
81506-8700
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-2141
  • Fax: 970-879-7912
Mailing address:
  • Phone: 970-683-7107
  • Fax: 970-683-7167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9923733
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: