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NPI Code Detail

MEDICARE: TREE OF LIFE PSYCHIATRY

MEDICARE: TREE OF LIFE PSYCHIATRY
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1942056080
Entity Type Code : Organization
Provider Name (Legal Business Name) : TREE OF LIFE PSYCHIATRY
Provider Business Mailing Address
First Line : 3449 VAUGHN VIEW DR
Second Line :
City : PUEBLO
State : CO
Zip : 81005-9750
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1189 S PERRY ST STE 140
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80104-1990
Country : US
Telephone Number : 719-417-5754
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ASHLEY BENALLY-ROSS
Credential : PMHNP
Telephone Number : 719-439-3641
Provider Enumeration Date : 04/29/2024
Last Update Date : 12/11/2025

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Directions to “TREE OF LIFE PSYCHIATRY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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