Provider Demographics
NPI:1285486191
Name:GLENNON-LEVIN, SIERRA
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:GLENNON-LEVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 ZENOBIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1653
Mailing Address - Country:US
Mailing Address - Phone:610-945-7590
Mailing Address - Fax:
Practice Address - Street 1:1527 COLE BLVD STE 275
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3423
Practice Address - Country:US
Practice Address - Phone:720-706-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.00000016971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical