Provider Demographics
NPI:1750754222
Name:DEMOULIN, DANA (LCSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:DEMOULIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 W 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-0177
Mailing Address - Country:US
Mailing Address - Phone:303-329-0870
Mailing Address - Fax:303-328-2304
Practice Address - Street 1:6750 W 52ND AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3928
Practice Address - Country:US
Practice Address - Phone:303-329-0870
Practice Address - Fax:303-394-0871
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.009914261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical