Individual provider Active NPI

Wouter Roos, LPCC

  • Professional Counselor
  • Englewood, CO
National Provider Identifier
1124705884
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0016956 Issued in CO
Practice address
3250 W Saratoga Ave
Englewood, CO 80110-6202
Phone
(720) 317-7605
NPI assigned
Jul 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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 0016956 CO Primary

Addresses

Primary practice location

3250 W Saratoga Ave
Englewood, CO 80110-6202

Mailing address

3250 W Saratoga Ave
Englewood, CO 80110-6202
Phone (720) 317-7605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0016956COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1124705884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 W SARATOGA AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801106202",
            "telephone_number": "720-317-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W SARATOGA AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801106202",
            "telephone_number": "720-317-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOS",
        "first_name": "WOUTER",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0016956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.