Provider Demographics
NPI:1154448363
Name:ZIZMOR, LAURA BETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:BETH
Last Name:ZIZMOR
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 1:5984 S PRINCE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2083
Mailing Address - Country:US
Mailing Address - Phone:303-738-1021
Mailing Address - Fax:303-738-1047
Practice Address - Street 1:5984 S PRINCE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2083
Practice Address - Country:US
Practice Address - Phone:303-738-1021
Practice Address - Fax:303-738-1047
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical