Provider Demographics
NPI:1902573280
Name:LINDA GOERNER PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:LINDA GOERNER PSYCHOTHERAPY, LLC
Other - Org Name:GROWING FAMILIES TOGETHER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GOERNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-717-7412
Mailing Address - Street 1:2349 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3142
Mailing Address - Country:US
Mailing Address - Phone:303-717-7412
Mailing Address - Fax:303-321-6984
Practice Address - Street 1:1750 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1057
Practice Address - Country:US
Practice Address - Phone:303-717-7412
Practice Address - Fax:303-321-6984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO006953Medicaid
CO77155076Medicaid