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General NPI Number Information
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NPI Number | 1639612021
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Entity Type | Individual
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Provider Name | MICHELLE DE NOOY LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 6240 S MAIN ST SUITE 265
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City | AURORA
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State | CO
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Zip | 80016-5376
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Country | US
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Telephone | 720-274-5287
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Fax | 720-274-5267
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Provider Business Mailing Address
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Address Line | 6240 S MAIN ST SUITE 265
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City | AURORA
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State | CO
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Zip | 80016-5376
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Country | US
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Telephone | 720-274-5287
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Fax | 720-274-5267
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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.09924337
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License Number State | CO
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