Provider Demographics
NPI:1316198021
Name:DEVILLE, NATALIE WILDER (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:WILDER
Last Name:DEVILLE
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14360 ERIN CT
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9579
Mailing Address - Country:US
Mailing Address - Phone:720-252-5265
Mailing Address - Fax:
Practice Address - Street 1:363 S HARLAN ST STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3552
Practice Address - Country:US
Practice Address - Phone:303-922-3433
Practice Address - Fax:303-922-7335
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical