Provider Demographics
NPI:1306268180
Name:GUGLIELMO, SAVANNAH J (LCSW, LAC)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:J
Last Name:GUGLIELMO
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3813
Mailing Address - Country:US
Mailing Address - Phone:720-263-0058
Mailing Address - Fax:
Practice Address - Street 1:50 S STEELE ST STE 950
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2843
Practice Address - Country:US
Practice Address - Phone:720-263-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001111101YA0400X
103K00000X
COCSW.099261411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ8478Medicaid