Individual provider Active NPI

Andrew Newkirk Rose, LPC

  • Professional Counselor
  • Boulder, CO
National Provider Identifier
1053658930
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11337 Issued in CO
Practice address
3434 47TH St
Suite 101
Boulder, CO 80301-1880
Phone
(303) 225-2708
Fax
(303) 225-2708
NPI assigned
Jan 11, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11337 CO Primary

Addresses

Primary practice location

3434 47TH St
Suite 101
Boulder, CO 80301-1880

Mailing address

1177 Fourmile Canyon Dr
Boulder, CO 80302-9743
Phone (303) 532-6780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208003224 CO Practitioner - Mental Health Counselor 4981047792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healingquest LLPGroup PAC ID 3072956887, 8 clinicians

Practice addresses (Care Compare)

3434 47TH St
Suite 130
Boulder, CO 80301-1802
Phone 3032252708100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11337COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healingquest LLC CurrentSince Jan 1, 2024 Accepting new patients
Healingquest LLP Past Accepting new patients
Healingquest LLP Past Accepting new patients
Healingquest LLP Past Accepting new patients
Healingquest LLP Professional Past Accepting new patients

Locations

3434 47th St
Ste 130
Boulder, CO 80301
Phone (303) 225-2708

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1053658930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 FOURMILE CANYON DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803029743",
            "telephone_number": "303-532-6780",
            "fax_number": "303-225-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 47TH ST",
            "address_2": "SUITE 101",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011880",
            "telephone_number": "303-225-2708",
            "fax_number": "303-225-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ANDREW",
        "middle_name": "NEWKIRK",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "11337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.