Provider Demographics
NPI:1720398274
Name:NICASTRI, JEANETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:NICASTRI
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 1:310 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1153
Mailing Address - Country:US
Mailing Address - Phone:720-284-8777
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:720-432-9610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.000013551041C0700X
CA21209101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health