Provider Demographics
NPI:1326043183
Name:SEMPLE, WILLIAM G (MSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:G
Last Name:SEMPLE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 FLORAL DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2738
Mailing Address - Country:US
Mailing Address - Phone:303-449-1669
Mailing Address - Fax:720-306-3263
Practice Address - Street 1:2030 FLORAL DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2738
Practice Address - Country:US
Practice Address - Phone:303-449-1669
Practice Address - Fax:720-306-3263
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9890701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO800681Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION #