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General NPI Number Information
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NPI Number | 1134015027
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Entity Type | Individual
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Provider Name | WILLIAM CORREA LSW
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Gender | Male
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR
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City | FORT CARSON
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State | CO
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Zip | 80913-4613
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Country | US
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Telephone | 440-670-7359
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Fax |
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Provider Business Mailing Address
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Address Line | 220 JOHNSTON ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80930-7001
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Country | US
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Telephone | 440-670-7359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0009926500
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License Number State | CO
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