Healthcare Provider Details

I. General information

NPI: 1932560828
Provider Name (Legal Business Name): COLORADO THERAPY & ASSESSMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2016
Last Update Date: 06/24/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 S BELLAIRE ST STE 390
DENVER CO
80222-4350
US

IV. Provider business mailing address

1777 S BELLAIRE ST STE 390
DENVER CO
80222-4350
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-4244
  • Fax:
Mailing address:
  • Phone: 720-515-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY4238
License Number StateCO

VIII. Authorized Official

Name: SARA LYNN ROSE
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 720-515-4244