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General NPI Number Information
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NPI Number | 1629759816
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Entity Type | Individual
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Provider Name | MICHAEL LOPEZ-JENSEN
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Gender | Male
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 3600 S YOSEMITE ST STE 1050
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City | DENVER
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State | CO
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Zip | 80237-1852
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Country | US
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Telephone | 303-756-3340
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Fax |
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Provider Business Mailing Address
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Address Line | 5655 S YOSEMITE ST STE 470
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3222
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Country | US
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Telephone | 720-219-7923
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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 | CSW-80
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License Number State | CO
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