Provider Demographics
NPI:1114911278
Name:PARKER, GEORGIANNE (MSW)
Entity Type:Individual
Prefix:MS
First Name:GEORGIANNE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:GEORGIANNE
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:1766 HIGH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1309
Mailing Address - Country:US
Mailing Address - Phone:303-321-6820
Mailing Address - Fax:
Practice Address - Street 1:1766 HIGH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1309
Practice Address - Country:US
Practice Address - Phone:303-321-6820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8762301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC97726Medicare PIN