Provider Demographics
NPI:1477260487
Name:BLANFORD, NICHOLE ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:ANNE
Last Name:BLANFORD
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 1:4958 S NELSON ST APT A
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-7958
Mailing Address - Country:US
Mailing Address - Phone:303-803-3591
Mailing Address - Fax:
Practice Address - Street 1:4958 S NELSON ST APT A
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-7958
Practice Address - Country:US
Practice Address - Phone:303-803-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099283951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical