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General NPI Number Information
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NPI Number | 1609472398
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Entity Type | Individual
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Provider Name | JEFFREY BRAGG BERTRAND LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 28101 E QUINCY AVE
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City | WATKINS
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State | CO
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Zip | 80137-9502
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Country | US
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Telephone | 303-730-8858
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Fax |
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Provider Business Mailing Address
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Address Line | 116 INVERNESS DR E STE 105
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5125
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Country | US
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Telephone | 303-730-8858
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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 | 0009923158
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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 | CSW.09931473
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License Number State | CO
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