1114077336 NPI number — DR. RACHELLE ANN SUTTEN PSY.D.

Table of content: DR. RACHELLE ANN SUTTEN PSY.D. (NPI 1114077336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114077336 NPI number — DR. RACHELLE ANN SUTTEN PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUTTEN
Provider First Name:
RACHELLE
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUTTEN COATS
Provider Other First Name:
RACHELLE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSY.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1114077336
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9543 W CALEY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80123-3103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-756-5400
Provider Business Mailing Address Fax Number:
303-972-6463

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8340 SANGRE DE CRISTO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80127-4248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-756-5400
Provider Business Practice Location Address Fax Number:
303-972-6463
Provider Enumeration Date:
01/11/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  452 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 2800 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)