Provider Demographics
NPI:1902504541
Name:GOFF, GRAYLEN DIANE (LPCC)
Entity Type:Individual
Prefix:
First Name:GRAYLEN
Middle Name:DIANE
Last Name:GOFF
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23084 N TURKEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-9029
Mailing Address - Country:US
Mailing Address - Phone:719-249-0984
Mailing Address - Fax:
Practice Address - Street 1:2305 E ARAPAHOE RD STE 240
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1565
Practice Address - Country:US
Practice Address - Phone:720-706-2957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health