MEDICARE: LINDA GOERNER PSYCHOTHERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902573280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA GOERNER PSYCHOTHERAPY, LLC

Provider Business Mailing Address
First Line	:	2349 CHERRY ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3142
Country	:	US
Telephone Number	:	303-717-7412
Fax Number	:	303-321-6984

Provider Business Practice Location Address
First Line	:	1750 COLORADO BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-1057
Country	:	US
Telephone Number	:	303-717-7412
Fax Number	:	303-321-6984

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	LINDA ANNE GOERNER
Credential	:	LPC
Telephone Number	:	303-717-7412

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	09/23/2022

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