Healthcare Provider Details

I. General information

NPI: 1902821952
Provider Name (Legal Business Name): STEVEN PAUL RAUCH L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2864 S CIRCLE DR SUITE 500
COLORADO SPRINGS CO
80906-4114
US

IV. Provider business mailing address

2864 S CIRCLE DR SUITE 500
COLORADO SPRINGS CO
80906-4114
US

V. Phone/Fax

Practice location:
  • Phone: 719-531-9211
  • Fax: 719-577-9627
Mailing address:
  • Phone: 719-531-9211
  • Fax: 719-577-9627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number989731
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: