Provider Demographics
NPI:1548520166
Name:LIFEWORKS RECOVERY
Entity type:Organization
Organization Name:LIFEWORKS RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CACII
Authorized Official - Phone:303-895-5527
Mailing Address - Street 1:1455 AMMONS ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-6110
Mailing Address - Country:US
Mailing Address - Phone:303-953-3480
Mailing Address - Fax:303-953-3482
Practice Address - Street 1:1455 AMMONS ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-6110
Practice Address - Country:US
Practice Address - Phone:303-953-3480
Practice Address - Fax:303-953-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1674-00251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health