Provider Demographics
NPI:1801596895
Name:WEINKAUF, ROBERT DUANE
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DUANE
Last Name:WEINKAUF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10610 STATE HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80651-7907
Mailing Address - Country:US
Mailing Address - Phone:303-641-1722
Mailing Address - Fax:
Practice Address - Street 1:710 11TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-6405
Practice Address - Country:US
Practice Address - Phone:970-880-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC0003718106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist