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General NPI Number Information
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NPI Number | 1881728285
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Entity Type | Individual
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Provider Name | TRISHA S GOETZ LCSW, CACIII
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 3292 PEORIA ST
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City | AURORA
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State | CO
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Zip | 80010-1517
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Country | US
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Telephone | 303-343-6130
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Fax | 303-344-0664
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Provider Business Mailing Address
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Address Line | 3701 S BROADWAY
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3611
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Country | US
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Telephone | 303-360-6276
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Fax | 303-467-5355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.00992613
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACC.0006038
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License Number State | CO
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