Provider Demographics
NPI:1063127868
Name:ROCKY MOUNTAIN CENTER FOR RELATIONSHIPS AND SEXUAL INTIMACY, PLLC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN CENTER FOR RELATIONSHIPS AND SEXUAL INTIMACY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:720-571-9396
Mailing Address - Street 1:19590 E MAINSTREET STE 202
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7371
Mailing Address - Country:US
Mailing Address - Phone:720-571-9396
Mailing Address - Fax:
Practice Address - Street 1:19590 E MAINSTREET STE 202
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7371
Practice Address - Country:US
Practice Address - Phone:720-571-9396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty