Provider Demographics
NPI:1245596857
Name:AMESBURY, DEBORAH BAILEY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:BAILEY
Last Name:AMESBURY
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 1:400 S. LAFAYETTE STREET
Mailing Address - Street 2:#503
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-5500
Mailing Address - Country:US
Mailing Address - Phone:303-744-1817
Mailing Address - Fax:
Practice Address - Street 1:400 S LAFAYETTE ST
Practice Address - Street 2:#503
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2536
Practice Address - Country:US
Practice Address - Phone:303-744-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9891021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical