Basic Information
| Provider Information | |||||||||
| NPI: | 1457595712 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARNDEN | ||||||||
| FirstName: | ALISA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MSW LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DEAN | ||||||||
| OtherFirstName: | ALISA | ||||||||
| OtherMiddleName: | M | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MSW LCSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 715 HORIZON DR | ||||||||
| Address2: | STE 225 | ||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815068700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706837107 | ||||||||
| FaxNumber: | 9706837167 | ||||||||
| Practice Location | |||||||||
| Address1: | 407 SOUTH LINCOLN AVE | ||||||||
| Address2: | |||||||||
| City: | STEAMBOAT SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708792141 | ||||||||
| FaxNumber: | 9708797912 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2009 | ||||||||
| LastUpdateDate: | 01/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 9923733 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.