Provider Demographics
NPI:1003554098
Name:BICKNELL, LILLIAN CHRISTINE (LSW)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:CHRISTINE
Last Name:BICKNELL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 W COLFAX AVE APT 273
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2265
Mailing Address - Country:US
Mailing Address - Phone:720-829-7153
Mailing Address - Fax:
Practice Address - Street 1:2855 N SPEER BLVD # 80211
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4239
Practice Address - Country:US
Practice Address - Phone:720-829-1853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009923054104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker