Provider Demographics
NPI:1356495840
Name:ROZDZIAL, MOSHE MORRIS (LPC)
Entity Type:Individual
Prefix:DR
First Name:MOSHE
Middle Name:MORRIS
Last Name:ROZDZIAL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 W SYCAMORE CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2261
Mailing Address - Country:US
Mailing Address - Phone:303-666-7043
Mailing Address - Fax:
Practice Address - Street 1:3500 E 17TH AVE
Practice Address - Street 2:#3
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1813
Practice Address - Country:US
Practice Address - Phone:303-399-2314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3569101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional