=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932585452
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUDITH THUROW LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2015
-----------------------------------------------------
Last Update Date | 08/06/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 609 W LITTLETON BLVD STE 201
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80120-2352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-505-0262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9150 E CENTER AVE APT 2A
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80247-1292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-505-0262
-----------------------------------------------------
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 | 00989452
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------