Healthcare Provider Details

I. General information

NPI: 1932861432
Provider Name (Legal Business Name): EMMA ROAN RHOMBERG MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA ROAN SEAVEY

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 30TH ST STE 213
BOULDER CO
80301-1087
US

IV. Provider business mailing address

1800 30TH ST
BOULDER CO
80301-1088
US

V. Phone/Fax

Practice location:
  • Phone: 303-351-2314
  • Fax:
Mailing address:
  • Phone: 303-351-2314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09926083
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

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: