1750562500 NPI number — WILLIAM FRANCIS KONECNIK MA, MSW, LICSW

Table of content: WILLIAM FRANCIS KONECNIK MA, MSW, LICSW (NPI 1750562500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750562500 NPI number — WILLIAM FRANCIS KONECNIK MA, MSW, LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KONECNIK
Provider First Name:
WILLIAM
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, MSW, LICSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KONECNIK
Provider Other First Name:
OWEN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, MSW, LICSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1750562500
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 S COLORADO BLVD
Provider Second Line Business Mailing Address:
TOWER 1, SUITE 2000-4
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80222-7900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-884-9682
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 S COLORADO BLVD
Provider Second Line Business Practice Location Address:
TOWER 1, SUITE 2000-4
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80222-7900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-884-9682
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  18104 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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