Basic Information
| Provider Information | |||||||||
| NPI: | 1104290956 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A WORK IN PROCESS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2066 | ||||||||
| Address2: | |||||||||
| City: | BROOMFIELD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800382066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039175073 | ||||||||
| FaxNumber: | 7205368597 | ||||||||
| Practice Location | |||||||||
| Address1: | 6363 W 120TH AVE | ||||||||
| Address2: | SUITE 312 | ||||||||
| City: | BROOMFIELD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800200300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039175073 | ||||||||
| FaxNumber: | 7205368597 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2015 | ||||||||
| LastUpdateDate: | 11/17/2015 | ||||||||
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| AuthorizedOfficialLastName: | DUNNING | ||||||||
| AuthorizedOfficialFirstName: | LENA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3039175073 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 09923453 | CO | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.