Provider Demographics
NPI:1154979318
Name:HEPWORTH, GENA DU BOIS (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:GENA
Middle Name:DU BOIS
Last Name:HEPWORTH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 37TH AVENUE CT UNIT 102
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2500
Mailing Address - Country:US
Mailing Address - Phone:970-352-6830
Mailing Address - Fax:970-352-1945
Practice Address - Street 1:1015 37TH AVENUE CT UNIT 102
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2500
Practice Address - Country:US
Practice Address - Phone:970-352-6830
Practice Address - Fax:970-352-1945
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical