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General NPI Number Information
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NPI Number | 1609672138
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Entity Type | Organization
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Legal Business Name | GREENLAKE PSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 1201 S PARKER RD STE 102
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City | DENVER
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State | CO
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Zip | 80231-2154
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Country | US
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Telephone | 720-310-0251
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S PARKER RD STE 102
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City | DENVER
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State | CO
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Zip | 80231-2154
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Country | US
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Telephone | 720-310-0251
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. RACHEL TOVA GALL
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Credential | PHD
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Telephone | 720-310-0251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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