Provider Demographics
NPI:1376651414
Name:SPENDELOW, JUDITH HALL (MSW, PSYD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:HALL
Last Name:SPENDELOW
Suffix:
Gender:F
Credentials:MSW, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 E. EXPOSITION AVE.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:303-777-5058
Mailing Address - Fax:303-316-7352
Practice Address - Street 1:3955 E. EXPOSITION AVE.
Practice Address - Street 2:SUITE 202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209
Practice Address - Country:US
Practice Address - Phone:303-777-5058
Practice Address - Fax:303-316-7352
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2467103TC0700X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1417962234OtherGROUP NPI
CO841044412OtherPRACTISE TAX ID
COU1536Medicare ID - Type UnspecifiedPROVIDER ID