Provider Demographics
NPI:1437195088
Name:BOERSMA, RICHARD RONALD (MS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:RONALD
Last Name:BOERSMA
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 LINCOLN AVENUE, SUITE 2000
Mailing Address - Street 2:P.O. BOX 770240
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-4444
Mailing Address - Country:US
Mailing Address - Phone:970-879-7637
Mailing Address - Fax:970-871-6811
Practice Address - Street 1:810 LINCOLN AVE
Practice Address - Street 2:SUITE 2000
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-4972
Practice Address - Country:US
Practice Address - Phone:970-879-7637
Practice Address - Fax:970-871-6811
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health