MEDICARE: KELLY OOSTERHOUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPCC.0024228	CO

General Provider Information

NPI Number	:	1326904814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY OOSTERHOUS

Provider Business Mailing Address
First Line	:	4115 SWANSON WAY UNIT 101
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-6336
Country	:	US
Telephone Number	:	720-916-5771
Fax Number	:

Provider Business Practice Location Address
First Line	:	4115 SWANSON WAY UNIT 101
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-6336
Country	:	US
Telephone Number	:	720-916-5771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	01/06/2026

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