Provider Demographics
NPI:1508445123
Name:EMERALD ROSE COUNSELING & PSYCHIATRY LLC
Entity Type:Organization
Organization Name:EMERALD ROSE COUNSELING & PSYCHIATRY LLC
Other - Org Name:EMERALD ROSE COUNSELING & PSYCHIATRY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:L
Authorized Official - Last Name:GROB
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:720-779-1998
Mailing Address - Street 1:4891 INDEPENDENCE ST STE 225
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6849
Mailing Address - Country:US
Mailing Address - Phone:720-779-1998
Mailing Address - Fax:720-596-5093
Practice Address - Street 1:4891 INDEPENDENCE ST STE 225
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6849
Practice Address - Country:US
Practice Address - Phone:720-779-1998
Practice Address - Fax:720-596-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty