Gretchen Larue Pangilinan, MA

Primary specialty

Art TherapistTaxonomy code 221700000X

Practice address

3005 47TH St Ste F4
Boulder, CO 80301-5550

Phone

(303) 295-1828

NPI assigned

Jan 23, 2021

Last updated

Jan 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1285224212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WILLOW PL",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800261120",
            "telephone_number": "303-817-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 47TH ST STE F4",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015550",
            "telephone_number": "303-295-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGILINAN",
        "first_name": "GRETCHEN",
        "middle_name": "LARUE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gretchen@wingedheartrootedspirit.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3005 47th St Ste F4",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803015550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.