Basic Information
Provider Information | |||||||||
NPI: | 1184816571 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | GYORFFY | ||||||||
FirstName: | MICHAEL | ||||||||
MiddleName: | JOSEPH | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | LCSW | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 750 W HAMPDEN AVE. | ||||||||
Address2: | SUITE 105 | ||||||||
City: | ENGLEWOOD | ||||||||
State: | CO | ||||||||
PostalCode: | 801102167 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7209747464 | ||||||||
FaxNumber: | 3039537274 | ||||||||
Practice Location | |||||||||
Address1: | 6080 W 92ND AVE STE 1000 | ||||||||
Address2: |   | ||||||||
City: | WESTMINSTER | ||||||||
State: | CO | ||||||||
PostalCode: | 800312935 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3034299311 | ||||||||
FaxNumber: | 3034299399 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/10/2007 | ||||||||
LastUpdateDate: | 07/24/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 3107 | KY | N |   | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 09924816 | CO | Y |   | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.