Provider Demographics
NPI:1083150320
Name:HEWITT, LAURIE KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:KAY
Last Name:HEWITT
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 1:7165 S GAYLORD ST APT H5
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1644
Mailing Address - Country:US
Mailing Address - Phone:303-738-1151
Mailing Address - Fax:
Practice Address - Street 1:7165 S GAYLORD ST APT H5
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1644
Practice Address - Country:US
Practice Address - Phone:303-738-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9896101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical