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General NPI Number Information
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NPI Number | 1386029916
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Entity Type | Individual
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Provider Name | JESSICA GERSHWIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 2149 FEDERAL BLVD
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City | DENVER
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State | CO
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Zip | 80211-4639
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Country | US
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Telephone | 303-825-3850
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Fax |
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Provider Business Mailing Address
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Address Line | 9551 W 38TH AVE
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-4225
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Country | US
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Telephone | 720-220-7525
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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 | 09924025
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License Number State | CO
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