Provider Demographics
NPI:1164052601
Name:MONTERROSO, GERALDINE ELENA
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:ELENA
Last Name:MONTERROSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 S LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3425
Mailing Address - Country:US
Mailing Address - Phone:303-828-8595
Mailing Address - Fax:
Practice Address - Street 1:3131 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2203
Practice Address - Country:US
Practice Address - Phone:720-255-0924
Practice Address - Fax:303-455-1332
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015958101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health