Provider Demographics
NPI:1780128504
Name:RINK, GEOFFREY (MA)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:
Last Name:RINK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 WILCOX ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1709
Mailing Address - Country:US
Mailing Address - Phone:720-935-2663
Mailing Address - Fax:
Practice Address - Street 1:734 WILCOX ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1709
Practice Address - Country:US
Practice Address - Phone:720-935-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC0106104101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional