Provider Demographics
NPI:1811445539
Name:BOEHLE-SATTERFIELD, TAMI JOAN (LCSW-C)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:JOAN
Last Name:BOEHLE-SATTERFIELD
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-7503
Mailing Address - Country:US
Mailing Address - Phone:410-382-0518
Mailing Address - Fax:
Practice Address - Street 1:829 13TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7503
Practice Address - Country:US
Practice Address - Phone:410-382-0518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLCSW.000238961041C0700X
MD159781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical