Provider Demographics
NPI:1952931420
Name:RUETZ, ROBYN ELYSIA (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:ELYSIA
Last Name:RUETZ
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 W 44TH AVE STE 402B
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6826
Mailing Address - Country:US
Mailing Address - Phone:720-459-1200
Mailing Address - Fax:719-350-4272
Practice Address - Street 1:10200 W 44TH AVE STE 402B
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6826
Practice Address - Country:US
Practice Address - Phone:720-459-1200
Practice Address - Fax:719-350-4272
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89148101YM0800X
COLPC.0017932101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000200871Medicaid