Provider Demographics
NPI:1427594530
Name:ROCKY MOUNTAIN PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-956-6219
Mailing Address - Street 1:6655 W JEWELL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-7108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6655 W JEWELL AVE STE 103
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-7108
Practice Address - Country:US
Practice Address - Phone:303-956-6219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO772251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health