Provider Demographics
NPI:1861848616
Name:MCDOUGAL, TAMMY (MSW, LSW, SWC)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:MCDOUGAL
Suffix:
Gender:F
Credentials:MSW, LSW, SWC
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:MCDOUGAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LSW, SWC
Mailing Address - Street 1:1500 N GRANT ST STE R
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1747
Mailing Address - Country:US
Mailing Address - Phone:720-878-3037
Mailing Address - Fax:
Practice Address - Street 1:8700 TURNPIKE DR STE 400
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7033
Practice Address - Country:US
Practice Address - Phone:720-878-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.00000026291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty