Provider Demographics
NPI:1093452245
Name:PHELPS, CATHY DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:DENISE
Last Name:PHELPS
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:PO BOX 18975
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-0975
Mailing Address - Country:US
Mailing Address - Phone:303-860-0660
Mailing Address - Fax:303-831-7282
Practice Address - Street 1:1751 N GILPIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1205
Practice Address - Country:US
Practice Address - Phone:303-860-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1031104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker