Provider Demographics
NPI:1477851145
Name:CHAVEZ, GILBERT WAYNE JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:WAYNE
Last Name:CHAVEZ
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1212 S BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-1583
Mailing Address - Country:US
Mailing Address - Phone:303-934-1008
Mailing Address - Fax:303-934-1262
Practice Address - Street 1:1212 S BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-1583
Practice Address - Country:US
Practice Address - Phone:303-934-1008
Practice Address - Fax:303-934-1262
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical