Provider Demographics
NPI:1942334495
Name:TENORIO, ABE EUGENE (LCSW)
Entity Type:Individual
Prefix:
First Name:ABE
Middle Name:EUGENE
Last Name:TENORIO
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 1:6238 S FOREST CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3423
Mailing Address - Country:US
Mailing Address - Phone:303-770-7038
Mailing Address - Fax:
Practice Address - Street 1:6238 S FOREST CT
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-3423
Practice Address - Country:US
Practice Address - Phone:303-770-7038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO93830491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO03852067Medicaid