Provider Demographics
NPI:1003342379
Name:JOSEPH, ANNA (MSW, MPH)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14211 E 4TH AVE STE 3-138
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8736
Mailing Address - Country:US
Mailing Address - Phone:720-262-8067
Mailing Address - Fax:
Practice Address - Street 1:14211 E 4TH AVE STE 3-138
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8736
Practice Address - Country:US
Practice Address - Phone:720-262-8067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0106175104100000X
COCSW.099256901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCSW.09925690OtherCOLORADO LICENSED CLINICAL SOCIAL WORKER NUMBER
CONLC.0106175OtherCOLORADO REGISTERED PSYCHOTHERAPIST NUMBER