Provider Demographics
NPI:1588997175
Name:DE VORE, CELESTE MONIQUE (MSW, LSW)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:MONIQUE
Last Name:DE VORE
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-1629
Mailing Address - Country:US
Mailing Address - Phone:208-949-6368
Mailing Address - Fax:
Practice Address - Street 1:145 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-1629
Practice Address - Country:US
Practice Address - Phone:208-949-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW-521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker