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General NPI Number Information
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NPI Number | 1225306715
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Entity Type | Organization
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Legal Business Name | CENTER FOR COMMUNITY EXCELLENCE AND SOCIAL JUSTICE
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 1600 DOWNING ST SUITE 200
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City | DENVER
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State | CO
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Zip | 80218-1573
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Country | US
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Telephone | 303-831-4500
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Fax | 303-831-4499
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Provider Business Mailing Address
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Address Line | 1600 DOWNING ST SUITE 200
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City | DENVER
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State | CO
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Zip | 80218-1573
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Country | US
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Telephone | 303-831-4500
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Fax | 303-831-4499
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARJORIE BARBARA LEWIS
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Credential | PH.D, LMFT, LAC
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Telephone | 303-831-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 44
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 624
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License Number State | CO
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