Tina Marie Rose, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY.0004324 Issued in CO

Practice address

1115 Elkton Dr Ste 102
Colorado Springs, CO 80907-3597

Phone

(719) 357-6471

Fax

(719) 434-9811

NPI assigned

Aug 11, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Colorado Springs Psychological Services

  • Clinical Psychologist
  • Denver, CO
  • NPI 1699373621
  NPD
• Edc of Denver, LLC

  • Psychiatric Hospital
  • Denver, CO
  • NPI 1124165923
  NPD (past)

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1851700280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 WOODCOCK ST APT O4",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805137030",
            "telephone_number": "970-689-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 ELKTON DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073597",
            "telephone_number": "719-357-6471",
            "fax_number": "719-434-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0004324",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "7190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Rose
• Sali Jo Rose, M.A.,CCC-SLP
• Shaun Donovan Rose
• Susan Mary Rose, RDH
• Tara L Rose, MA, CCC-SLP
• Zachary Rose
• Rosebud Birthing Services
• Christine Rosemark
• Adina Rosen, LCSW
• Tracy L Rosen

• Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.