Provider Demographics
NPI:1467537936
Name:TRACEY ANDREWS LCSW PC
Entity Type:Organization
Organization Name:TRACEY ANDREWS LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCSW CAC III
Authorized Official - Phone:303-691-9220
Mailing Address - Street 1:1720 S BELLAIRE STREET
Mailing Address - Street 2:STE 906
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4333
Mailing Address - Country:US
Mailing Address - Phone:303-691-9220
Mailing Address - Fax:303-777-7651
Practice Address - Street 1:1720 S BELLAIRE STREET
Practice Address - Street 2:STE 906
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4333
Practice Address - Country:US
Practice Address - Phone:303-691-9220
Practice Address - Fax:303-777-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2480101YA0400X
CO9895371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty