Provider Demographics
NPI:1538944574
Name:ROSICKY, CHARLES JOSEPH (LCSW)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:JOSEPH
Last Name:ROSICKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:CHARLEY
Other - Middle Name:
Other - Last Name:ROSICKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:287 CENTURY CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1684
Mailing Address - Country:US
Mailing Address - Phone:720-310-8241
Mailing Address - Fax:
Practice Address - Street 1:287 CENTURY CIR STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1684
Practice Address - Country:US
Practice Address - Phone:720-310-8241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical