Aquamind Psychiatry PLLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Fort Collins, CO

NPI 1083455992 · NPPES record last updated Jun 4, 2024

Key facts

NPI
1083455992
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
AQUAMIND PSYCHIATRY PLLC
Practice address
1608 Whedbee St
Fort Collins, CO 80525-1045
Phone
(404) 406-2763
Fax
(970) 788-7279
NPI assigned
Jun 4, 2024
Organization subpart
No

Authorized official

Name
Rosa Cruz Kauffman, MSN, PMHNP-BC
Title
Owner
Phone
(404) 406-2763

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240830001371 CO Part B Supplier - Clinic/Group Practice 7911446216 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Collins, CO

National Provider Directory

Locations

301 S Howes St
Ste 2101
Fort Collins, CO 80521

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

1608 Whedbee St
Fort Collins, CO 80525-1045

Mailing address

1608 Whedbee St
Fort Collins, CO 80525-1045
Phone (404) 406-2763

Other identifiers

IdentifierTypeStateIssuer
1457715831MedicaidCO

Other names

  • AquaMind Psych Doing business as

Other providers in Fort Collins, CO

All providers in Fort Collins, CO · Psychiatric/Mental Health Nurse Practitioner in Colorado

Sources for this page

Verify at the official NPI Registry.