Provider Demographics
NPI:1780021501
Name:SOSSI, TANIA CHRISTINA
Entity Type:Individual
Prefix:MS
First Name:TANIA
Middle Name:CHRISTINA
Last Name:SOSSI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TANIA
Other - Middle Name:CHRISTINA
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:10190 BANNOCK STREET
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80260
Mailing Address - Country:US
Mailing Address - Phone:303-656-1203
Mailing Address - Fax:
Practice Address - Street 1:10190 BANNOCK STREET
Practice Address - Street 2:SUITE 109
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80260
Practice Address - Country:US
Practice Address - Phone:303-656-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011978101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty