MEDICARE: ANNA PENDLETON 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	CSW.09933259	CO

General Provider Information

NPI Number	:	1689507261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA PENDLETON LCSW

Provider Business Mailing Address
First Line	:	5165 SANTA CLARA PL APT C
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80303-4169
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2406 W 32ND AVE STE D
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-3373
Country	:	US
Telephone Number	:	720-288-0706
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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