MEDICARE: GRACE RIPPERGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1255086252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE RIPPERGER

Provider Business Mailing Address
First Line	:	12211 W ALAMEDA PKWY STE 201
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-2825
Country	:	US
Telephone Number	:	405-822-8993
Fax Number	:

Provider Business Practice Location Address
First Line	:	12211 W ALAMEDA PKWY STE 201
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-2825
Country	:	US
Telephone Number	:	405-822-8993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2022
Last Update Date	:	02/17/2022

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Directions to “ GRACE RIPPERGER ” Practice Location

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