Provider Demographics
NPI:1861702722
Name:HANDRAN, JONI MICHELLE (LCSW, CAC III)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:MICHELLE
Last Name:HANDRAN
Suffix:
Gender:F
Credentials:LCSW, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 N SPEER BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3764
Mailing Address - Country:US
Mailing Address - Phone:720-261-7042
Mailing Address - Fax:866-271-5038
Practice Address - Street 1:2150 W 29TH AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3844
Practice Address - Country:US
Practice Address - Phone:720-261-7042
Practice Address - Fax:866-271-5038
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6431101YA0400X
CO835104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)