Provider Demographics
NPI:1881151272
Name:DAISS-LUCAS, JILL (LCSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DAISS-LUCAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:DAISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12766 W 61ST PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3924
Mailing Address - Country:US
Mailing Address - Phone:303-204-9246
Mailing Address - Fax:
Practice Address - Street 1:5335 W 48TH AVE STE 500
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2732
Practice Address - Country:US
Practice Address - Phone:720-288-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099251301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical