Provider Demographics
NPI:1760646103
Name:HOROWITZ, EMILY GOLD (MA)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:GOLD
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CANYON BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5619
Mailing Address - Country:US
Mailing Address - Phone:303-880-8296
Mailing Address - Fax:
Practice Address - Street 1:2300 CANYON BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5619
Practice Address - Country:US
Practice Address - Phone:303-880-8296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
NY18 004719101YM0800X
CO13141101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health