Basic Information
Provider Information
NPI: 1801996426
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RYKKEN
FirstName: DEBORAH
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MARSH
OtherFirstName: DEBORAH
OtherMiddleName: R
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: LPC
OtherLastNameType: 5
Mailing Information
Address1: 11059 E. BETHANY DRIVE
Address2:  
City: AURORA
State: CO
PostalCode: 80014
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber: 3036172365
Practice Location
Address1: 11059 E. BETHANY DRIVE
Address2:  
City: AURORA
State: CO
PostalCode: 80014
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber: 3036172365
Other Information
ProviderEnumerationDate: 09/24/2006
LastUpdateDate: 05/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X1874COY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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