Provider Demographics
NPI:1336508936
Name:COUNSELING AND CASE MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:COUNSELING AND CASE MANAGEMENT SERVICES, LLC
Other - Org Name:AZRA SELAK, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AZRA
Authorized Official - Middle Name:HANNA
Authorized Official - Last Name:SELAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-318-3657
Mailing Address - Street 1:5700 BLUE SAGE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2716
Mailing Address - Country:US
Mailing Address - Phone:720-318-3657
Mailing Address - Fax:
Practice Address - Street 1:5700 BLUE SAGE DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2716
Practice Address - Country:US
Practice Address - Phone:720-318-3657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty