Basic Information
| Provider Information | |||||||||
| NPI: | 1003467507 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BANKERT | ||||||||
| FirstName: | MELODY | ||||||||
| MiddleName: | ANNA | ||||||||
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| Credential: | MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7951 E MAPLEWOOD AVE STE 350 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801114758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039307803 | ||||||||
| FaxNumber: | 3039305503 | ||||||||
| Practice Location | |||||||||
| Address1: | 4700 HALE PKWY STE 400 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802204051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033707954 | ||||||||
| FaxNumber: | 3033219296 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2019 | ||||||||
| LastUpdateDate: | 09/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 13946 | MD | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | CSW.09925890 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.