Healthcare Provider Details

I. General information

NPI: 1174286546
Provider Name (Legal Business Name): EDWIN MONTARULI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W HAMPDEN AVE STE 700
ENGLEWOOD CO
80110-2337
US

IV. Provider business mailing address

8000 W STANFORD AVE APT 201
DENVER CO
80123-7358
US

V. Phone/Fax

Practice location:
  • Phone: 303-309-2354
  • Fax:
Mailing address:
  • Phone: 832-792-5180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0014922
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: