MEDICARE: JULIA A GREGSON 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
1	1041C0700X	Clinical Social Worker	989499	CO

General Provider Information

NPI Number	:	1659369585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA A GREGSON LCSW

Provider Business Mailing Address
First Line	:	482 WEST HAPPY CANYON ROAD
Second Line	:
City	:	CASTLE PINES
State	:	CO
Zip	:	80108
Country	:	US
Telephone Number	:	720-291-5880
Fax Number	:	720-660-5351

Provider Business Practice Location Address
First Line	:	482 WEST HAPPY CANYON ROAD
Second Line	:
City	:	CASTLE PINES
State	:	CO
Zip	:	80108
Country	:	US
Telephone Number	:	720-291-5880
Fax Number	:	720-660-5351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	01/29/2015

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