Individual provider Active NPI

Amber Gulley

  • Mental Health Counselor
  • Broomfield, CO
National Provider Identifier
1417589946
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
340 E 1St Ave
Broomfield, CO 80020-2401
Phone
(720) 608-7686
NPI assigned
Feb 12, 2020
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CO Primary

Addresses

Primary practice location

340 E 1St Ave
Broomfield, CO 80020-2401

Mailing address

2633 E 111TH Dr
Northglenn, CO 80233-4643
Phone (303) 641-0310

Other identifiers 1

IdentifierTypeStateIssuer
0006321OtherCOCOLORADO DEPARTMENT OF REGULATORY AGENCY

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
I20240820000392 CO Practitioner - Mental Health Counselor 1759829955 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Neurology and Concussion PLLC CurrentSince Jun 1, 2024 Accepting new patients
Empower Mental Health LLC Mental Health CurrentSince Jun 1, 2024 Accepting new patients

Locations

340 E 1st Ave
Ste 300
Broomfield, CO 80020
Phone (303) 928-9693

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1417589946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 E 111TH DR",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802334643",
            "telephone_number": "303-641-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 E 1ST AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202401",
            "telephone_number": "720-608-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEY",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF REGULATORY AGENCY",
            "identifier": "0006321",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.