Provider Demographics
NPI:1285476937
Name:HEIL, JAX (MSW, SWC)
Entity type:Individual
Prefix:
First Name:JAX
Middle Name:
Last Name:HEIL
Suffix:
Gender:M
Credentials:MSW, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 S CLAYTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3527
Mailing Address - Country:US
Mailing Address - Phone:269-312-7795
Mailing Address - Fax:
Practice Address - Street 1:400 E SIMPSON ST STE 230
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2360
Practice Address - Country:US
Practice Address - Phone:970-415-7974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.00000019401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical