Provider Demographics
NPI:1508139551
Name:PASSOTH, COLLEEN MIN HEE (LMSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MIN HEE
Last Name:PASSOTH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 PEARL EAST CIR
Mailing Address - Street 2:STE 118 #688985
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4845 PEARL EAST CIR STE 118
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-6112
Practice Address - Country:US
Practice Address - Phone:303-917-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker