Healthcare Provider Details

I. General information

NPI: 1639928534
Provider Name (Legal Business Name): REBECCA J MOLENAAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 KING ST
DENVER CO
80219-1326
US

IV. Provider business mailing address

325 KING ST
DENVER CO
80219-1326
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-4100
  • Fax:
Mailing address:
  • Phone: 303-225-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0023267
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: