Provider Demographics
NPI:1699920439
Name:JUAREZ, CAROLYN ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANNE
Last Name:JUAREZ
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 1:1445 MILWAUKEE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2507
Mailing Address - Country:US
Mailing Address - Phone:303-653-3434
Mailing Address - Fax:
Practice Address - Street 1:1036 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6102
Practice Address - Country:US
Practice Address - Phone:303-443-6154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical