Provider Demographics
NPI:1295922862
Name:CHANDLER, JUDITH ANN (LCSW, CACIII)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LCSW, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CLERMONT STREET
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-399-8020
Mailing Address - Fax:303-393-5076
Practice Address - Street 1:1055 CLERMONT STREET
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:303-393-5076
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9880231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical