Provider Demographics
NPI:1265812416
Name:RUCH, CASEY
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:RUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 SUGARLOAF LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-2738
Mailing Address - Country:US
Mailing Address - Phone:720-378-8355
Mailing Address - Fax:
Practice Address - Street 1:1076 SUGARLOAF LN
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-2738
Practice Address - Country:US
Practice Address - Phone:720-378-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019924101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health