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NPI Code Detail

MEDICARE: NICHOLETTE MICHELLE FABRIZIO LCSW

MEDICARE: NICHOLETTE MICHELLE FABRIZIO 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 Worker09924166CO

General Provider Information

NPI Number : 1821309709
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLETTE MICHELLE FABRIZIO LCSW
Provider Business Mailing Address
First Line : 1440 GROVE ST UNIT A
Second Line :
City : DENVER
State : CO
Zip : 80204-2201
Country : US
Telephone Number : 719-821-3433
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 : 303-504-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2010
Last Update Date : 03/15/2022

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Directions to “ NICHOLETTE MICHELLE FABRIZIO LCSW” Practice Location

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