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NPI Code Detail

MEDICARE: KRISTI W. MOCK LCSW

MEDICARE: KRISTI W. MOCK 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 Worker989180CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1800014240OTHERCORAILROAD MEDICARE

General Provider Information

NPI Number : 1790777886
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI W. MOCK LCSW
Provider Business Mailing Address
First Line : 4455 E 12TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2415
Country : US
Telephone Number : 303-504-7700
Fax Number : 303-782-0916
Provider Business Practice Location Address
First Line : 4455 E 12TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2415
Country : US
Telephone Number : 303-504-7700
Fax Number : 303-782-0916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 03/17/2014

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Directions to “ KRISTI W. MOCK LCSW” Practice Location

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