Healthcare Provider Details

I. General information

NPI: 1962371690
Provider Name (Legal Business Name): ROBIN ROSE TEMPLE MA, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 38TH ST STE 100E
BOULDER CO
80301-2624
US

IV. Provider business mailing address

730 SANDPOINT DR
LONGMONT CO
80504-9273
US

V. Phone/Fax

Practice location:
  • Phone: 303-946-6030
  • Fax:
Mailing address:
  • Phone: 303-946-6030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberNLC-0108135
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: