Provider Demographics
NPI:1871811125
Name:PASSOTH, RICHARD ERNST (LMFT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ERNST
Last Name:PASSOTH
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:ERNST
Other - Last Name:PASSOTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:400 S LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2536
Mailing Address - Country:US
Mailing Address - Phone:801-364-3387
Mailing Address - Fax:
Practice Address - Street 1:138 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5105
Practice Address - Country:US
Practice Address - Phone:801-364-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6251349-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist