Healthcare Provider Details

I. General information

NPI: 1417370636
Provider Name (Legal Business Name): ROBERTA K GORSUCH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN GORSUCH LPC

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 09/11/2025
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 E PRENTICE AVE STE 300
GREENWOOD VILLAGE CO
80111-2906
US

IV. Provider business mailing address

18510 E MAINSTREET APT 1-206
PARKER CO
80134-4989
US

V. Phone/Fax

Practice location:
  • Phone: 720-489-8555
  • Fax: 720-489-8304
Mailing address:
  • Phone: 307-286-4225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPPC-813
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: