Healthcare Provider Details

I. General information

NPI: 1578310322
Provider Name (Legal Business Name): SUSAN HESS LPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 FOREST HILL RD
EVERGREEN CO
80439-5723
US

IV. Provider business mailing address

3719 EVERGREEN PKWY STE A-102
EVERGREEN CO
80439-7771
US

V. Phone/Fax

Practice location:
  • Phone: 303-246-5162
  • Fax:
Mailing address:
  • Phone: 303-246-5162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN J HESS
Title or Position: OWNER
Credential: LPC
Phone: 303-246-5162