Provider Demographics
NPI:1972960458
Name:GREENWOOD, DEBRA K (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:GREENWOOD-CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, UNDER SUPERVIS
Mailing Address - Street 1:PO BOX 5178
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80866-5178
Mailing Address - Country:US
Mailing Address - Phone:719-686-6703
Mailing Address - Fax:719-325-8985
Practice Address - Street 1:400 W MIDLAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-3199
Practice Address - Country:US
Practice Address - Phone:719-686-6703
Practice Address - Fax:719-325-8958
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
COCSW.099263371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK6579OtherOK STATE BOARD OF LICENSED SWKERS
COCSW.09926337OtherCO DEPARTMENT OF REGULATORY AGENCIES - STATE BOARD OF SWK EXAMINERS
OK5244OtherOK STATE BOARD OF LICENSED SWKERS