Provider Demographics
NPI:1306611736
Name:DUCKWORTH COLLABORATIVE THERAPY
Entity type:Organization
Organization Name:DUCKWORTH COLLABORATIVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUCKWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-635-9864
Mailing Address - Street 1:6093 S QUEBEC ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4543
Mailing Address - Country:US
Mailing Address - Phone:720-635-9864
Mailing Address - Fax:
Practice Address - Street 1:6093 S QUEBEC ST STE 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4543
Practice Address - Country:US
Practice Address - Phone:720-635-9864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty