Provider Demographics
NPI:1710414727
Name:DUGAN, AMBER (LSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DUGAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 S ULSTER ST APT 1403
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2865
Mailing Address - Country:US
Mailing Address - Phone:785-817-8242
Mailing Address - Fax:
Practice Address - Street 1:1220 S PARKER RD STE 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-7557
Practice Address - Country:US
Practice Address - Phone:720-295-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000099233931041S0200X
172V00000X
COLSW.0009923393104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No172V00000XOther Service ProvidersCommunity Health Worker