NPI 1104367366

Mountain Rose Counseling

Organisation Point of Service Lafayette, CO

Practice location

Address: 260 S 112th St, Lafayette, CO 80026-9031
Phone: (303) 647-5950
Mailing address: 4855 Edison Ave APT 114, Boulder, CO 80301-5429

Authorised official

Name: Miranda Dee Calhoun
Title: Owner
Phone: (720) 495-1616

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence LPCC.0015196 (CO)

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Registry record

NPI: 1104367366
Entity type: Organization
NPI issued: 20 Mar 2017
Record last updated: 20 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.