Provider Demographics
NPI:1346465234
Name:GREWAY, GLORIA SUZANNE (PHD LPC)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:SUZANNE
Last Name:GREWAY
Suffix:
Gender:F
Credentials:PHD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5386 DUNRAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-2058
Mailing Address - Country:US
Mailing Address - Phone:303-420-6455
Mailing Address - Fax:
Practice Address - Street 1:6700 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4732
Practice Address - Country:US
Practice Address - Phone:303-420-8080
Practice Address - Fax:303-420-9299
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
11688204OtherCAQH