Provider Demographics
NPI:1871053900
Name:TERKHORN, SUSAN (MA, LMFT, NCC, CST)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:TERKHORN
Suffix:
Gender:F
Credentials:MA, LMFT, NCC, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 E FLORIDA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2540
Mailing Address - Country:US
Mailing Address - Phone:303-523-8559
Mailing Address - Fax:
Practice Address - Street 1:2121 S ONEIDA ST STE 107
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2550
Practice Address - Country:US
Practice Address - Phone:720-336-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-24
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0107555101YM0800X
COLPCC.0015643101YM0800X
COMFT.0001785106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health