Provider Demographics
NPI:1023026275
Name:COOPER-NADAV, JAN (MSS, LCSW)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:COOPER-NADAV
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E 9TH AVE
Mailing Address - Street 2:#100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3394
Mailing Address - Country:US
Mailing Address - Phone:303-316-0954
Mailing Address - Fax:
Practice Address - Street 1:750 E 9TH AVE
Practice Address - Street 2:#100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3394
Practice Address - Country:US
Practice Address - Phone:303-316-0954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO992157101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional