Provider Demographics
NPI:1245565795
Name:ROSQUIST, COLETTE C (LCSW)
Entity Type:Individual
Prefix:
First Name:COLETTE
Middle Name:C
Last Name:ROSQUIST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:COLETTE
Other - Middle Name:C
Other - Last Name:ZOLG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:715 HORIZON DR STE 225
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:515 28 3/4 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-5016
Practice Address - Country:US
Practice Address - Phone:970-263-4918
Practice Address - Fax:970-683-7278
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19971041C0700X
UT6294870-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical