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NPI Code Detail

MEDICARE: ALLISON ANN SUSNICK CSW. 09923365

MEDICARE: ALLISON ANN SUSNICK CSW. 09923365
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 Worker09923365CO

General Provider Information

NPI Number : 1558657411
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON ANN SUSNICK CSW. 09923365
Provider Business Mailing Address
First Line : 1440 GROVE ST UNIT A
Second Line :
City : DENVER
State : CO
Zip : 80204-2201
Country : US
Telephone Number : 303-504-1500
Fax Number :
Provider Business Practice Location Address
First Line : 1440 GROVE ST UNIT A
Second Line :
City : DENVER
State : CO
Zip : 80204-2201
Country : US
Telephone Number : 303-504-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2011
Last Update Date : 11/11/2015

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