Provider Demographics
NPI:1316753809
Name:RAULERSON, HANNAH JOY (LSW)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:JOY
Last Name:RAULERSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 N EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3705
Mailing Address - Country:US
Mailing Address - Phone:863-801-0146
Mailing Address - Fax:
Practice Address - Street 1:10190 BANNOCK ST STE 120
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80260-6052
Practice Address - Country:US
Practice Address - Phone:303-237-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009925448104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker