| Pamela Goodfriend, Lcsw, Cac Iii | |
|
3570 E 12th Ave Ste 303 Denver CO 80206-3434 | |
| (303) 269-1191 | |
| (303) 395-1462 |
| Full Name | Pamela Goodfriend, Lcsw, Cac Iii |
|---|---|
| Speciality | Social Worker |
| Location | 3570 E 12th Ave Ste 303, Denver, Colorado |
| Authorized Official Name and Position | Pam G Cooper (PROVIDER) |
| Authorized Official Contact | 3032691191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela Goodfriend, Lcsw, Cac Iii 3570 E 12th Ave Ste 303 Denver CO 80206-3434 Ph: (303) 269-1191 | Pamela Goodfriend, Lcsw, Cac Iii 3570 E 12th Ave Ste 303 Denver CO 80206-3434 Ph: (303) 269-1191 |
| NPI Number | 1447655170 |
|---|---|
| Provider Enumeration Date | 10/23/2014 |
| Last Update Date | 04/30/2018 |
| Medicare PECOS PAC ID | 2860711736 |
|---|---|
| Medicare Enrollment ID | O20150428001507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447655170 | NPI | - | NPPES |
| 1700940368 | Other | CO | INDIVIDUAL MEDICARE NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 575 (Colorado) | Primary |
| Provider Name | Pamela Goodfriend Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700940368 PECOS PAC ID: 3779683628 Enrollment ID: I20070709000060 |
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