Healthcare Provider Details

I. General information

NPI: 1275611329
Provider Name (Legal Business Name): CANYON BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8704 YATES DRIVE SUITE 100D
WESTMINSTER CO
80031-6950
US

IV. Provider business mailing address

8704 YATES DRIVE SUITE 100D
WESTMINSTER CO
80031-6950
US

V. Phone/Fax

Practice location:
  • Phone: 303-430-4010
  • Fax: 303-430-5306
Mailing address:
  • Phone: 303-430-4010
  • Fax: 303-430-5306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY E. ROGERS
Title or Position: CO-OWNER
Credential: PSYD
Phone: 303-931-7444