Provider Demographics
NPI:1679397467
Name:BLANCK, CHELSEA (MSW, SWC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:BLANCK
Suffix:
Gender:X
Credentials:MSW, SWC
Other - Prefix:
Other - First Name:C
Other - Middle Name:
Other - Last Name:BLANCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, SWC
Mailing Address - Street 1:7555 W AMHERST AVE # 36106
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3494
Mailing Address - Country:US
Mailing Address - Phone:720-432-0751
Mailing Address - Fax:
Practice Address - Street 1:8805 W 14TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4848
Practice Address - Country:US
Practice Address - Phone:720-432-0751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.00000016361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical