Provider Demographics
NPI:1750130183
Name:GREEN, RACHEL
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 BANNOCK ST APT 1316
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4181
Mailing Address - Country:US
Mailing Address - Phone:303-601-1608
Mailing Address - Fax:
Practice Address - Street 1:12211 W ALAMEDA PKWY STE 201
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2825
Practice Address - Country:US
Practice Address - Phone:720-583-5668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health