Provider Demographics
NPI:1275628695
Name:DEWIT, JUDITH H (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:H
Last Name:DEWIT
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 1:1355 S COLORADO BLVD
Mailing Address - Street 2:SUITE 322
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3305
Mailing Address - Country:US
Mailing Address - Phone:303-757-3140
Mailing Address - Fax:
Practice Address - Street 1:1355 S COLORADO BLVD
Practice Address - Street 2:SUITE 322
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3305
Practice Address - Country:US
Practice Address - Phone:303-757-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9840101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO201054121Medicare UPIN
CO98286Medicare ID - Type Unspecified