| Jennifer Drake, LCSW | |
|
2429 S Prairie Ave, Pueblo, CO 81005-2886 | |
| (719) 564-5070 | |
| Not Available |
| Full Name | Jennifer Drake |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 2429 S Prairie Ave, Pueblo, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457501850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW.09930122 (Colorado) | Primary |
| Entity Name | Gateway To Success, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922348481 PECOS PAC ID: 3173885670 Enrollment ID: O20180321001712 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Drake, LCSW 2429 S Prairie Ave, Pueblo, CO 81005-2886 Ph: (719) 564-5070 | Jennifer Drake, LCSW 2429 S Prairie Ave, Pueblo, CO 81005-2886 Ph: (719) 564-5070 |
James Arthur Hull, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1002 Cedar St, Pueblo, CO 81004 Phone: 719-545-0578 | |
Jeremy Vasquez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 29 Lehigh Ave, Pueblo, CO 81005 Phone: 719-549-7843 | |
Ms. Mary Alice Mehess, LCSW, LAC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 20 Tamar Ct, Pueblo, CO 81005 Phone: 719-568-2531 | |
Desiree Butcher, CSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1301 E 7th St, Pueblo, CO 81001 Phone: 719-543-8711 Fax: 719-543-0171 | |
Karen Marie Irick, LCSW, LAC Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1530 W 17th St, Pueblo, CO 81003 Phone: 719-544-3150 | |
Justin M Gay, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4776 Eagleridge Cir, Pueblo, CO 81008 Phone: 719-584-5183 Fax: 719-584-5496 | |
Prudencio Cosyleon, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 417 W 13th St, Pueblo, CO 81003 Phone: 719-544-0877 Fax: 719-544-2033 |