Healthcare Provider Details

I. General information

NPI: 1790617884
Provider Name (Legal Business Name): BRETT CHRISTOPHER ROONEY LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 FIEDLER AVE UNIT 209
DILLON CO
80435-6930
US

IV. Provider business mailing address

PO BOX 8574
BRECKENRIDGE CO
80424-8561
US

V. Phone/Fax

Practice location:
  • Phone: 816-507-2208
  • Fax:
Mailing address:
  • Phone: 816-507-2208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022505
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: