Provider Demographics
NPI:1851798623
Name:DURBAHN, REBECCA GODSILL (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:GODSILL
Last Name:DURBAHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:HARTMAN
Other - Last Name:GODSILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2950 TENNYSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-3029
Mailing Address - Country:US
Mailing Address - Phone:720-855-3452
Mailing Address - Fax:303-433-9701
Practice Address - Street 1:2950 TENNYSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-3029
Practice Address - Country:US
Practice Address - Phone:720-855-3452
Practice Address - Fax:303-433-9701
Is Sole Proprietor?:No
Enumeration Date:2014-11-22
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical