Basic Information
Provider Information
NPI: 1730100348
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASEY LANSING
FirstName: SALLY
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LANSING
OtherFirstName: SARAH
OtherMiddleName: CASEY
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 721 S FILLMORE ST
Address2:  
City: DENVER
State: CO
PostalCode: 802094816
CountryCode: US
TelephoneNumber: 3039416444
FaxNumber:  
Practice Location
Address1: 1055 CLERMONT ST
Address2:  
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 3033998020
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/21/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X991452COY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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