COLORADO BOYS RANCH FOUNDATION (NPI# 1083749881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083749881 |
| Entity Type | Organization |
| Organization Name | COLORADO BOYS RANCH FOUNDATION |
| Practice Address |
12567 W Cedar Dr Ste 210 Lakewood CO 80228-2009 |
| Practice Telephone | 3036916095 |
| Practice Fax Number | 3033766372 |
| Mailing Telephone | 3036916095 |
| Mailing Fax Number | 3033766372 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2019-05-03 |
| Authorized Official Name | TOM ROSE (CEO) |
| Authorized Official Telephone | 3036916095 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0016029700001 | 05 | |
| CO | 1532032 | 05 | |
| VA | 000207250 | 05 | |
| MT | 4101658 | 05 | |
| NJ | 8271909 | 05 | |
| WY | 116119901 | 05 | |
| AK | HS375PI | 05 | |
| NM | 000E1265 | 05 | |
| DC | 034723300 | 05 |
| Other Name | Type Code |
|---|---|
| CBR YouthConnect | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | COLORADO BOYS RANCH FOUNDATION | 12567 W Cedar Dr Ste 101, Lakewood, CO 80228-2009 |
| Street Address |
12567 W CEDAR DR STE 210 |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80228-2009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396388260 | Andrea Wangaard | Social Worker | 12567 W Cedar Dr Ste 210, Lakewood, CO 80228-2009 | 2019-10-23 |
| 1447893532 | Kelsey Geiselman | Social Worker | 12567 W Cedar Dr Ste 210, Lakewood, CO 80228-2009 | 2019-10-22 |
| 1225679418 | Amanda Kristine Bicker | Counselor | 12567 W Cedar Dr Ste 210, Lakewood, CO 80228-2009 | 2019-09-30 |
| 1770871162 | Allison Hagen | Social Worker | 12567 W Cedar Dr Ste 210, Lakewood, CO 80228-2009 | 2011-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083570 | Lindsey Mae Beverly | Physician Assistant | Medical Plaza 2, 11700 W 2nd Pl, #350, Lakewood, CO 80228 | 2019-03-21 |
| 1881119931 | Cory J Frazier | Nurse Practitioner | 11600 W. 2nd Pl, Lakewood, CO 80228 | 2017-08-10 |
| 1508213885 | Chelsea Tucker | Counselor | 12157 W Cedar Dr Ste 207, Lakewood, CO 80228 | 2016-05-17 |
| 1972963841 | Shastin Gerbracht | Counselor | 12055 W 2nd Pl, Ste 200, Lakewood, CO 80228 | 2016-03-04 |
| 1073983375 | Suzanne Phillips | Behavioral Analyst | 200 Union Blvd. Ste. 200, Lakewood, Co. 80228, Denver, CO 80228 | 2015-09-29 |
| 1700265667 | April Mearsha | Doula | 12977 W Cedar Dr, 2-305, Lakewood, CO 80228 | 2015-05-26 |
| 1306233713 | Caleb Hedberg | Internal Medicine | 165 S Union Blvd Ste 800, Lakewood, CO 80228 | 2015-04-23 |
| 1972996288 | David Lindsey Currie | Counselor | 12055 W 2nd Place, Jefferson Ctr for Mental Health, Lakewood, CO 80228 | 2015-03-11 |
| 1619365533 | Michelle Broberg II | Technician | 12055 West 2nd Plaza, Lakewood, CO 80228 | 2014-12-30 |
| 1750789012 | Kayla Morrison | Social Worker | 12005 W 2nd Place, Lakewood, CO 80228 | 2014-12-18 |
| Find all providers in zip 80228 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637572 | Carolyn Walker | Counselor | 8805 W 14th Ave Ste 200, Lakewood, CO 80215-4848 | 2020-10-19 |
| 1538766480 | George Sutherland | Counselor | 857 Fenton St, Lakewood, CO 80214-2437 | 2020-10-05 |
| 1144839929 | Hollowell Counseling LLC | Counselor | 1619 Onondaga Ave, Lakewood, OH 44107-4310 | 2020-07-28 |
| 1891349130 | Tiffany Montano | Counselor | 1597 Cole Blvd Ste 250, Lakewood, CO 80401-3417 | 2019-07-25 |
| 1528536943 | Mariah Rossel | Counselor | 8211 Rocky Mountain Dr, Lakewood, CO 80214-5546 | 2018-11-03 |
| 1033686688 | Dmitra R Danilenko-dixon | Counselor | 12567 W Cedar Dr Ste 100, Lakewood, CO 80228-2041 | 2018-10-31 |
| 1093294779 | Guided Perspectives LLC | Counselor | 15644 Madison Ave Ste 208, Lakewood, OH 44107-5622 | 2018-08-13 |
| 1467955138 | Deanna Adriano | Counselor | 7873 W Mansfield Pkwy Unit 2-104, Lakewood, CO 80235-3327 | 2018-03-08 |
| 1568964773 | Maria A Jonas | Counselor | 700 Lakewood Ave, Lakewood, NJ 08701 | 2018-03-03 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.