Provider Demographics
NPI:1366067027
Name:SUAREZ QUIROGA, SANTIAGO NICOLAS (BA, CACII)
Entity type:Individual
Prefix:MR
First Name:SANTIAGO
Middle Name:NICOLAS
Last Name:SUAREZ QUIROGA
Suffix:
Gender:M
Credentials:BA, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9061 JUDSON ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3348
Mailing Address - Country:US
Mailing Address - Phone:720-999-7727
Mailing Address - Fax:
Practice Address - Street 1:8407 BRYANT ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3809
Practice Address - Country:US
Practice Address - Phone:303-487-7776
Practice Address - Fax:303-487-7868
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB.0008264101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)