Provider Demographics
NPI:1699384677
Name:DOLPHIN, TAEGAN L (LCSW)
Entity Type:Individual
Prefix:
First Name:TAEGAN
Middle Name:L
Last Name:DOLPHIN
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 1:10952 EMERALD LN
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-7615
Mailing Address - Country:US
Mailing Address - Phone:302-300-5028
Mailing Address - Fax:
Practice Address - Street 1:2000 S COLORADO BLVD
Practice Address - Street 2:TOWER 1, SUITE 2000-4
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7900
Practice Address - Country:US
Practice Address - Phone:303-884-9682
Practice Address - Fax:303-474-6521
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099267371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical