Healthcare Provider Details

I. General information

NPI: 1609672138
Provider Name (Legal Business Name): GREENLAKE PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S PARKER RD STE 102
DENVER CO
80231-2154
US

IV. Provider business mailing address

1201 S PARKER RD STE 102
DENVER CO
80231-2154
US

V. Phone/Fax

Practice location:
  • Phone: 720-310-0251
  • Fax:
Mailing address:
  • Phone: 720-310-0251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. RACHEL TOVA GALL
Title or Position: OWNER/PSYCHOLOGIST
Credential: PHD
Phone: 720-310-0251