Provider Demographics
NPI:1992226880
Name:ULIBARRI-MCGILL, LORETTA A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:A
Last Name:ULIBARRI-MCGILL
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 1:1290 CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-7117
Mailing Address - Country:US
Mailing Address - Phone:303-617-2424
Mailing Address - Fax:303-343-1076
Practice Address - Street 1:5500 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8201
Practice Address - Country:US
Practice Address - Phone:303-730-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0107215104100000X
COCSW.099277251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO$$$$$$$$$Medicaid