Provider Demographics
NPI:1053661389
Name:FLORES, MARIA MAGDALENA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MAGDALENA
Last Name:FLORES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3257
Mailing Address - Country:US
Mailing Address - Phone:480-452-7795
Mailing Address - Fax:
Practice Address - Street 1:155 INVERNESS DR W
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5095
Practice Address - Country:US
Practice Address - Phone:480-452-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-127621041C0700X
COCSW.099233211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical