Provider Demographics
NPI:1134237381
Name:HOOVER, MARY ELIZABETH (MSW, LCSW, CACIII)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MSW, LCSW, CACIII
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW, CACIII
Mailing Address - Street 1:165 COOK ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5803
Mailing Address - Country:US
Mailing Address - Phone:303-940-4901
Mailing Address - Fax:303-940-4901
Practice Address - Street 1:165 COOK ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5803
Practice Address - Country:US
Practice Address - Phone:303-940-4901
Practice Address - Fax:303-940-4901
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9912521041C0700X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)