Provider Demographics
NPI:1538563192
Name:DOLLOFF, JUDITH
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:DOLLOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:ELAINE
Other - Last Name:BURNSIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1725 IRIS ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-2926
Mailing Address - Country:US
Mailing Address - Phone:303-274-4882
Mailing Address - Fax:
Practice Address - Street 1:7828 VANCE DR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2124
Practice Address - Country:US
Practice Address - Phone:720-217-5131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW009894051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical