Provider Demographics
NPI:1487865317
Name:CARREL, DOUGLAS D (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:D
Last Name:CARREL
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 S RACE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4606
Mailing Address - Country:US
Mailing Address - Phone:303-399-4166
Mailing Address - Fax:303-733-1511
Practice Address - Street 1:55 MADISON ST
Practice Address - Street 2:SUITE 600
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206
Practice Address - Country:US
Practice Address - Phone:303-399-4166
Practice Address - Fax:303-733-1511
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9897111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical