=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720744055
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANESSA N. SCHUELER LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2021
-----------------------------------------------------
Last Update Date | 11/10/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3801 E FLORIDA AVE STE 640
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80210-2544
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-224-2315
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2770 S ELMIRA ST UNIT 21
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80231-3920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-224-2315
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CSW.09927260
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------