Provider Demographics
NPI:1588335376
Name:DUNHAM-ORTH, ROBERT THOMAS (LPCC0018908)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:THOMAS
Last Name:DUNHAM-ORTH
Suffix:
Gender:M
Credentials:LPCC0018908
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 BROADWAY STE 1600
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-4916
Mailing Address - Country:US
Mailing Address - Phone:859-640-4554
Mailing Address - Fax:
Practice Address - Street 1:2600 9TH ST APT C4
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3325
Practice Address - Country:US
Practice Address - Phone:859-640-4554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional