Emergence Psychedelic Therapy, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EMERGENCE PSYCHEDELIC THERAPY, LLC

Practice address

825 S Broadway St Ste 100
Boulder, CO 80305-5932

Phone

(303) 578-8845

NPI assigned

Oct 22, 2025

Last updated

Jan 23, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacy Green, MDNPI 1558686162

Title

Owner

Phone

(720) 442-3565

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy Robin Green, M.D.

  • General Practice Physician
  • Boulder, CO
  • NPI 1558686162
  NPD Authorized official

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1407723497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S BROADWAY ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055932",
            "telephone_number": "303-578-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S BROADWAY ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055932",
            "telephone_number": "303-578-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCE PSYCHEDELIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-22",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-442-3565",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee Deann Elmont, OD
• Rachael Elrod-Martinez, LAC
• Mary G Elsea, DC
• Angela Ely
• Embodied Essence, PLLC (True Essence Therapy, PLLC)
• Christopher Emerson, MA
• Nathan Emerson
• Susan A. Emerson, PA-C
• James Emery, M.A.,L.P.C.
• Kathy Emery, MA, LPC

• Clinic/Center in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.