Provider Demographics
NPI:1487853818
Name:SHEILA GOETZ, M.A., CCC & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SHEILA GOETZ, M.A., CCC & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:303-709-3500
Mailing Address - Street 1:655 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6923
Mailing Address - Country:US
Mailing Address - Phone:303-440-0952
Mailing Address - Fax:303-440-0952
Practice Address - Street 1:825 S BROADWAY ST
Practice Address - Street 2:SUITE 90
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5963
Practice Address - Country:US
Practice Address - Phone:303-709-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO533522262Medicaid