MEDICARE: MR. RYAN COLBY ROGERS M.ED.

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	LPC.001339	CO

General Provider Information

NPI Number	:	1962715318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RYAN COLBY ROGERS M.ED.

Provider Business Mailing Address
First Line	:	3570 E 12TH AVE STE 107
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3431
Country	:	US
Telephone Number	:	423-779-6922
Fax Number	:

Provider Business Practice Location Address
First Line	:	3570 E 12TH AVE STE 107
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3431
Country	:	US
Telephone Number	:	423-779-6922
Fax Number	:

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

Provider Enumeration Date	:	07/14/2010
Last Update Date	:	04/03/2025

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