Provider Demographics
NPI:1821255712
Name:GORSKY, TERRI RAE (MHW)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:RAE
Last Name:GORSKY
Suffix:
Gender:F
Credentials:MHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 W 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2706
Mailing Address - Country:US
Mailing Address - Phone:303-455-9411
Mailing Address - Fax:
Practice Address - Street 1:3304 W 35TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-2706
Practice Address - Country:US
Practice Address - Phone:303-455-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO100322OtherSCHOOL DISTRICT IDENTIFING NUMBER JEFFERSON COUNTY PUBLIC SCHOOLS MEDICAID