Provider Demographics
NPI:1821214123
Name:MEEHAN, THOMAS W (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:W
Last Name:MEEHAN
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 1:3300 E 1ST AVE
Mailing Address - Street 2:SUITE 470
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5810
Mailing Address - Country:US
Mailing Address - Phone:303-643-8993
Mailing Address - Fax:303-942-5757
Practice Address - Street 1:3300 E 1ST AVE
Practice Address - Street 2:SUITE 470
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5810
Practice Address - Country:US
Practice Address - Phone:303-643-8993
Practice Address - Fax:303-942-5757
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9830391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical