Provider Demographics
NPI:1659771319
Name:JUDITHH. DEWIT, LCSW PC
Entity Type:Organization
Organization Name:JUDITHH. DEWIT, LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:H
Authorized Official - Last Name:DEWIT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LCSW
Authorized Official - Phone:303-757-3140
Mailing Address - Street 1:1355 S COLORADO BLVD
Mailing Address - Street 2:SUITE # 322
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3305
Mailing Address - Country:US
Mailing Address - Phone:303-757-3140
Mailing Address - Fax:
Practice Address - Street 1:1355 S COLORADO BLVD
Practice Address - Street 2:SUITE # 322
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3305
Practice Address - Country:US
Practice Address - Phone:303-757-3140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9840101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98286Medicare PIN