=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063358521
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGHAN ANNEMARIE BACKOFEN LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2026
-----------------------------------------------------
Last Update Date | 04/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 214 8TH ST STE 203
-----------------------------------------------------
City | GLENWOOD SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81601-3312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-945-3763
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1040 PARK WEST CT
-----------------------------------------------------
City | GLENWOOD SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81601-4525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 301
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------