Provider Demographics
NPI:1851747232
Name:ROGGOW, BRIANNA ROSE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:ROSE
Last Name:ROGGOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BRIANNA
Other - Middle Name:ROSE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:3401 EUDORA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-2500
Mailing Address - Country:US
Mailing Address - Phone:720-619-0511
Mailing Address - Fax:
Practice Address - Street 1:3401 EUDORA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2500
Practice Address - Country:US
Practice Address - Phone:303-504-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099251691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical