Provider Demographics
NPI:1114162021
Name:ATAYDE, MARCELA FERNANDEZ (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCELA
Middle Name:FERNANDEZ
Last Name:ATAYDE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARCELA
Other - Middle Name:
Other - Last Name:FERNANDEZ-VANROO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12591 FIRENZE HTS
Mailing Address - Street 2:APT 2111
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921
Mailing Address - Country:US
Mailing Address - Phone:505-526-5201
Mailing Address - Fax:562-981-7569
Practice Address - Street 1:12591 FIRENZE HTS
Practice Address - Street 2:APT 2111
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921
Practice Address - Country:US
Practice Address - Phone:505-526-5201
Practice Address - Fax:562-981-7569
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 226741041C0700X
COCSW.099249481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical