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General NPI Number Information
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NPI Number | 1285008391
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Entity Type | Individual
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Provider Name | JASON GREGORY STAHNKE LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 6105 S MAIN ST STE 200
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City | AURORA
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State | CO
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Zip | 80016-5361
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Country | US
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Telephone | 720-448-7820
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Fax |
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Provider Business Mailing Address
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Address Line | 6105 S MAIN ST
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City | AURORA
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State | CO
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Zip | 80016-5360
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Country | US
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Telephone | 720-448-7820
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09923904
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0009920176
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2015019167
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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