MEDICARE: ANXIETY AND OCD UNSTUCK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1184267338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANXIETY AND OCD UNSTUCK

Provider Business Mailing Address
First Line	:	3050 BROADWAY ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3050 BROADWAY ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3154
Country	:	US
Telephone Number	:	303-997-8571
Fax Number	:

Authorized Official
Title or Position	:	LCSW
Name	:	NATALIE HENRY
Credential	:
Telephone Number	:	303-997-8571

Provider Enumeration Date	:	10/21/2019
Last Update Date	:	10/21/2019

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