Provider Demographics
NPI:1770255028
Name:TELLEZ, ANTHONY (MSW, CSWC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:TELLEZ
Suffix:
Gender:M
Credentials:MSW, CSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 ACOMA ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4029
Mailing Address - Country:US
Mailing Address - Phone:303-831-9344
Mailing Address - Fax:
Practice Address - Street 1:1045 ACOMA ST STE 3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4029
Practice Address - Country:US
Practice Address - Phone:915-487-5904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical