Basic Information
| Provider Information | |||||||||
| NPI: | 1639383300 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHISTLER | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW, LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4455 E 12TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802202415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035046500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4455 E 12TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802202415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035046500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2007 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | ACD.0001003 | CO | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 104100000X | 886 | CO | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | CSW.09924002 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.