Provider Demographics
NPI:1093421190
Name:CORDES, GINA GRACE (LCSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:GRACE
Last Name:CORDES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:GRACE
Other - Last Name:MALNATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7400 E CRESTLINE CIR STE 145
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3656
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7400 E CRESTLINE CIR STE 145
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3656
Practice Address - Country:US
Practice Address - Phone:303-601-9069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099275641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty