Provider Demographics
NPI:1699315291
Name:DESAI, KUSH TARUN (LCSW)
Entity type:Individual
Prefix:MR
First Name:KUSH
Middle Name:TARUN
Last Name:DESAI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N GRANT ST # 4785
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1859
Mailing Address - Country:US
Mailing Address - Phone:970-422-7218
Mailing Address - Fax:970-236-4080
Practice Address - Street 1:1500 N GRANT ST # 4785
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-1859
Practice Address - Country:US
Practice Address - Phone:970-422-7218
Practice Address - Fax:970-236-4080
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2025-09-01
Deactivation Date:2020-04-02
Deactivation Code:
Reactivation Date:2020-04-08
Provider Licenses
StateLicense IDTaxonomies
WYLCSW-13351041C0700X
COCSW.099279381041C0700X, 1041C0700X
DEQ1-00118981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000181492Medicaid
WY205170200Medicaid
CO9000181492Medicaid