Healthcare Provider Details

I. General information

NPI: 1609472398
Provider Name (Legal Business Name): JEFFREY BRAGG BERTRAND LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28101 E QUINCY AVE
WATKINS CO
80137-9502
US

IV. Provider business mailing address

116 INVERNESS DR E STE 105
ENGLEWOOD CO
80112-5125
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-8858
  • Fax:
Mailing address:
  • Phone: 303-730-8858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0009923158
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09931473
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: