Provider Demographics
NPI:1427384643
Name:POWERS, AMELIA GAYLE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:GAYLE
Last Name:POWERS
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 1:4495 HALE PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-6210
Mailing Address - Country:US
Mailing Address - Phone:303-877-6310
Mailing Address - Fax:
Practice Address - Street 1:4495 HALE PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-6210
Practice Address - Country:US
Practice Address - Phone:303-877-6310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical