Provider Demographics
NPI:1679644355
Name:ORSUND, JAMES KENNEDY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KENNEDY
Last Name:ORSUND
Suffix:
Gender:M
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:PO BOX 1124
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80437-1124
Mailing Address - Country:US
Mailing Address - Phone:720-289-1703
Mailing Address - Fax:
Practice Address - Street 1:3082 EVERGREEN PKWY STE D
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7968
Practice Address - Country:US
Practice Address - Phone:720-289-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.000001261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty