Healthcare Provider Details

I. General information

NPI: 1568385433
Provider Name (Legal Business Name): SUZANNA GLEASON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 W HAMPDEN AVE STE 350
ENGLEWOOD CO
80110-2233
US

IV. Provider business mailing address

750 W HAMPDEN AVE STE 350
ENGLEWOOD CO
80110-2233
US

V. Phone/Fax

Practice location:
  • Phone: 303-872-1734
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number91813
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0023646
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: