Provider Demographics
NPI:1538114160
Name:LUTHERAN SOCIAL SERVICES OF COLORADO
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF COLORADO
Other - Org Name:LUTHERAN FAMILY SERVICES ROCKY MOUNTAINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SERVICES SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-988-4634
Mailing Address - Street 1:1035 OSAGE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4209
Mailing Address - Country:US
Mailing Address - Phone:303-922-3433
Mailing Address - Fax:
Practice Address - Street 1:1035 OSAGE ST FL 7
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4206
Practice Address - Country:US
Practice Address - Phone:303-922-3433
Practice Address - Fax:303-922-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
536458Medicare ID - Type Unspecified