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NPI Code Detail

MEDICARE: TERRI LYNN HAMBLEN LCSW

MEDICARE: TERRI LYNN HAMBLEN LCSW
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
1101YA0400XAddiction (Substance Use Disorder) Counselor3727CO
21041C0700XClinical Social Worker989147CO

General Provider Information

NPI Number : 1265428767
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRI LYNN HAMBLEN LCSW
Provider Business Mailing Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-7801
Fax Number : 303-504-7892
Provider Business Practice Location Address
First Line : 4455 E 12TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2415
Country : US
Telephone Number : 303-504-7801
Fax Number : 303-504-7892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 12/24/2015

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Directions to “ TERRI LYNN HAMBLEN LCSW” Practice Location

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