Provider Demographics
NPI:1427544865
Name:ALDEN-WOODCOCK, KACI MARIE (LSW)
Entity type:Individual
Prefix:
First Name:KACI
Middle Name:MARIE
Last Name:ALDEN-WOODCOCK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:KACI
Other - Middle Name:MARIE
Other - Last Name:WOODCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:12150 RACE ST APT L302
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3332
Mailing Address - Country:US
Mailing Address - Phone:970-689-9534
Mailing Address - Fax:
Practice Address - Street 1:12150 RACE ST APT L302
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80241-3332
Practice Address - Country:US
Practice Address - Phone:970-689-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW0009921311104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLSW0009921311OtherDORA SOCIAL WORK LICENSE NUMBER