Provider Demographics
NPI:1982788105
Name:BORTZ, LIBBY LORETTA (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:LIBBY
Middle Name:LORETTA
Last Name:BORTZ
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 SUMMER WIND LN
Mailing Address - Street 2:# 4404
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2486
Mailing Address - Country:US
Mailing Address - Phone:303-798-1110
Mailing Address - Fax:303-798-3215
Practice Address - Street 1:2927 SUMMER WIND LN
Practice Address - Street 2:# 4404
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2486
Practice Address - Country:US
Practice Address - Phone:303-523-1108
Practice Address - Fax:303-267-0625
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8760211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
910266Medicare ID - Type Unspecified