Provider Demographics
NPI:1548400864
Name:BIGELSON, WENDY LISA (LCSW,ACSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:LISA
Last Name:BIGELSON
Suffix:
Gender:F
Credentials:LCSW,ACSW
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:BIGELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW,ACSW
Mailing Address - Street 1:2395 HILLSDALE WAY
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5623
Mailing Address - Country:US
Mailing Address - Phone:303-499-3505
Mailing Address - Fax:
Practice Address - Street 1:5277 MANHATTAN CIR
Practice Address - Street 2:SUITE 110
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-8201
Practice Address - Country:US
Practice Address - Phone:303-543-5785
Practice Address - Fax:303-543-5782
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9893471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical