Provider Demographics
NPI:1154684371
Name:VERGEIRE, SUSAN L (LPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:VERGEIRE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10352 HEATHERGLEN CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-8970
Mailing Address - Country:US
Mailing Address - Phone:720-244-8239
Mailing Address - Fax:
Practice Address - Street 1:155 INVERNESS DR W
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5095
Practice Address - Country:US
Practice Address - Phone:303-793-9634
Practice Address - Fax:303-889-0838
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6440101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional