Individual provider · Type 1 NPI

Dominique Edgerly, LCSW

Clinical Social Worker · Greeley, CO

NPI number 1205563012 Active

Practice location

928 12th St
Greeley, CO 80631-4024

Call (970) 347-2120 Map

Mailing address

1300 N 17th Ave
Greeley, CO 80631-9584

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XCSW.09932370 (CO)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1205563012

Dominique Edgerly, LCSW's National Provider Identifier is 1205563012, issued on Aug 2, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Greeley, CO. The record was last updated on Oct 3, 2025.