Provider Demographics
NPI:1558759829
Name:ROCHE, ROBIN LEE (MA, NCC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:ROCHE
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LEE
Other - Last Name:WEEKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:3401 EUDORA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207
Practice Address - Country:US
Practice Address - Phone:303-300-6160
Practice Address - Fax:303-355-5002
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013231101YM0800X, 101YP2500X
CO0104237171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0013231OtherDORA LPC