Provider Demographics
NPI:1659369585
Name:GREGSON, JULIA A (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:GREGSON
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 1:482 WEST HAPPY CANYON ROAD
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108
Mailing Address - Country:US
Mailing Address - Phone:720-291-5880
Mailing Address - Fax:720-660-5351
Practice Address - Street 1:482 WEST HAPPY CANYON ROAD
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108
Practice Address - Country:US
Practice Address - Phone:720-291-5880
Practice Address - Fax:720-660-5351
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9894991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA109037Medicare UPIN