Healthcare Provider Details

I. General information

NPI: 1225689839
Provider Name (Legal Business Name): ANDREW KENZO GOTO M.S. CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 N STEELE ST
DENVER CO
80205-3613
US

IV. Provider business mailing address

1860 N LINCOLN ST
DENVER CO
80203-2996
US

V. Phone/Fax

Practice location:
  • Phone: 720-424-1080
  • Fax:
Mailing address:
  • Phone: 207-423-4004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ9312
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0005488
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: