Provider Demographics
NPI:1659422020
Name:LAZEAR, SHELLEY KAUFHER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:KAUFHER
Last Name:LAZEAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:
Other - Last Name:KAUFHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6180 S FULTON ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5423
Mailing Address - Country:US
Mailing Address - Phone:303-771-1858
Mailing Address - Fax:
Practice Address - Street 1:3540 S POPLAR ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1360
Practice Address - Country:US
Practice Address - Phone:303-523-6020
Practice Address - Fax:303-771-5254
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9895581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical