Provider Demographics
NPI:1053571802
Name:SINCLAIR, GARY DEAN (PHD, LMSW)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:DEAN
Last Name:SINCLAIR
Suffix:
Gender:M
Credentials:PHD, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 IVANHOE WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8533
Mailing Address - Country:US
Mailing Address - Phone:970-201-4848
Mailing Address - Fax:
Practice Address - Street 1:2470 PATTERSON RD STE 6OFFICE5
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1028
Practice Address - Country:US
Practice Address - Phone:970-201-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS42181041C0700X
CO099259121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical