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NPI Code Detail

MEDICARE: SUSAN JANE KRILL-SMITH LCSW

MEDICARE: SUSAN JANE KRILL-SMITH 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
11041C0700XClinical Social Worker982006CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396959904
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN JANE KRILL-SMITH LCSW
Provider Business Mailing Address
First Line : 3738 W PRINCETON CIR
Second Line :
City : DENVER
State : CO
Zip : 80236-3110
Country : US
Telephone Number : 303-781-7875
Fax Number : 303-762-2196
Provider Business Practice Location Address
First Line : 3738 W PRINCETON CIR
Second Line :
City : DENVER
State : CO
Zip : 80236-3110
Country : US
Telephone Number : 303-781-7875
Fax Number : 303-762-2196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/08/2007

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