| Maia Longenecker, LCSW | |
|
8931 Huron St, Thornton, CO 80260-6806 | |
| (303) 853-3500 | |
| Not Available |
| Full Name | Maia Longenecker |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 8931 Huron St, Thornton, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497180129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW.0992330 (Colorado) | Primary |
| Entity Name | Blue Channel Therapy |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811587199 PECOS PAC ID: 0941653364 Enrollment ID: O20240201000494 |
| Mailing Address | Practice Location Address |
|---|---|
| Maia Longenecker, LCSW 8931 Huron St, Thornton, CO 80260-6806 Ph: (303) 853-3500 | Maia Longenecker, LCSW 8931 Huron St, Thornton, CO 80260-6806 Ph: (303) 853-3500 |
Cameron C James, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8931 Huron St, Thornton, CO 80260 Phone: 303-853-3500 | |
Brittney Bobadilla, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12723 Dexter Ct, Thornton, CO 80241 Phone: 720-938-9486 | |
Eileen Pfefferle, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8931 Huron St, Thornton, CO 80260 Phone: 303-853-3500 | |
Silvia Yareli Lazaro-estala, MSW., LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 8801 Fox Dr Ste 305, Thornton, CO 80260 Phone: 720-440-2686 | |
Ms. Susanna C Mandics, MSW, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 8931 Huron St, Thornton, CO 80260 Phone: 303-853-3500 | |
Krista Kachich, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8931 Huron St, Thornton, CO 80260 Phone: 303-853-3500 | |
Amanda Marie Mrkvicka, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13362 Pearl Cir, Thornton, CO 80241 Phone: 303-960-4106 |