Provider Demographics
NPI:1417370636
Name:GORSUCH, ROBERTA K (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:K
Last Name:GORSUCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:GORSUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:18510 E MAINSTREET APT 1-206
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4989
Mailing Address - Country:US
Mailing Address - Phone:307-286-4225
Mailing Address - Fax:
Practice Address - Street 1:8301 E PRENTICE AVE STE 300
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2906
Practice Address - Country:US
Practice Address - Phone:720-489-8555
Practice Address - Fax:720-489-8304
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPPC-813101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional