SAMANTHA MACE GOTHBERG NPI 1831866847

NPI Information

NPI: 1831866847
Provider Name: SAMANTHA MACE GOTHBERG
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
360 EBY CREEK ROAD
EAGLE, CO
ZIP 81631
Phone: (970) 306-4673
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Samantha Mace Gothberg is a mental health counselor in Eagle, CO. Samantha Mace Gothberg NPI is 1831866847. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

360 EBY CREEK ROAD
EAGLE, CO
ZIP 81631
Phone: (970) 306-4673

The enumeration date for this NPI number is 8/26/2021 and was last updated on 8/26/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	LPCC.0017147	COLORADO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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