Healthcare Provider Details

I. General information

NPI: 1306772835
Provider Name (Legal Business Name): PSYCHIATRIC SERVICES OF THE ROCKIES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 MIDPOINT DR STE 202
FORT COLLINS CO
80525-4341
US

IV. Provider business mailing address

2121 MIDPOINT DR STE 202
FORT COLLINS CO
80525-4341
US

V. Phone/Fax

Practice location:
  • Phone: 970-632-9540
  • Fax:
Mailing address:
  • Phone: 970-632-9540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY WILLIAMSON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 303-578-9834