1477702298 NPI number — MS. STEPHANIE RACHEL SPEER LCSW

Table of content: MS. STEPHANIE RACHEL SPEER LCSW (NPI 1477702298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477702298 NPI number — MS. STEPHANIE RACHEL SPEER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPEER
Provider First Name:
STEPHANIE
Provider Middle Name:
RACHEL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PEARSON
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
RACHEL
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477702298
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11059 E. BETHANY DRIVE
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80014-9811
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-617-2300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1504 GALENA STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-617-2300
Provider Business Practice Location Address Fax Number:
303-504-0294
Provider Enumeration Date:
09/17/2008

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: 1041C0700X , with the licence number:  CSW.00001871 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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