Active NPI
Amber Gulley
- Mental Health Counselor
- Broomfield, CO
National Provider Identifier
1417589946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 340 E 1St Ave
Broomfield, CO 80020-2401 - Phone
- (720) 608-7686
- NPI assigned
- Feb 12, 2020
- Last updated
- Jul 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006321 | Other | CO | COLORADO 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Neurology and Concussion PLLC | Current | Accepting new patients | |
| Empower Mental Health LLC | Mental Health | Current | 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.
-
dba Ellie Mental Health - Broomfield West
- Mental Health Counselor
- Broomfield, CO
- NPI 1699462697
-
dba Boulder Neurology and Concussion
- Neurology Physician
- Louisville, CO
- NPI 1336622570
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.