MEDICARE: MS. VICKI RANERI ROBBINS LCSW CACIII

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	3556 CACIII	CO
2	104100000X	Social Worker	876355	CO

General Provider Information

NPI Number	:	1750391025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICKI RANERI ROBBINS LCSW CACIII

Provider Business Mailing Address
First Line	:	90 MADISON ST
Second Line	:	STE 306
City	:	DENVER
State	:	CO
Zip	:	80206-5412
Country	:	US
Telephone Number	:	303-355-6107
Fax Number	:	303-377-2093

Provider Business Practice Location Address
First Line	:	90 MADISON ST
Second Line	:	STE 306
City	:	DENVER
State	:	CO
Zip	:	80206-5412
Country	:	US
Telephone Number	:	303-355-6107
Fax Number	:

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	01/06/2022

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