Provider Demographics
NPI:1952566739
Name:NOVACEK, VERA G (LCSW)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:G
Last Name:NOVACEK
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 1:501 S CHERRY ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 S CHERRY ST
Practice Address - Street 2:SUITE 700
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1325
Practice Address - Country:US
Practice Address - Phone:303-321-2828
Practice Address - Fax:303-329-7422
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9893721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO535378Medicare PIN