Provider Demographics
NPI:1346542719
Name:OLDEWAGE, CAROLYN MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE
Last Name:OLDEWAGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 16TH ST STE 1460
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5202
Mailing Address - Country:US
Mailing Address - Phone:303-472-4536
Mailing Address - Fax:
Practice Address - Street 1:23776 CODY PARK RD
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9317
Practice Address - Country:US
Practice Address - Phone:303-472-4536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099251911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical