Basic Information
| Provider Information | |||||||||
| NPI: | 1487797387 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRICHTON | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | CLARKE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.C.S.W. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CLARKE CRICHTON | ||||||||
| OtherFirstName: | MELISSA | ||||||||
| OtherMiddleName: | BROTHERTON | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | L.C.S.W, | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 155 INVERNESS DR W | ||||||||
| Address2: | STE. 200 | ||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801125095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037939634 | ||||||||
| FaxNumber: | 3038890838 | ||||||||
| Practice Location | |||||||||
| Address1: | 6509 S SANTA FE DR | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801202910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037939634 | ||||||||
| FaxNumber: | 3038890838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 05/20/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 989120 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 989120 | 01 | CO | LCSW # IN COLORADO | OTHER |