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Marie Claire Roderick Psyd Llc
Adolescent and Children Mental Health Clinic/Center in Broomfield, Colorado
NPI 1174246466

Marie Claire Roderick Psyd Llc is an Adolescent and Children Mental Health Clinic/Center based in Broomfield, CO and is specialized in Adolescent and Children Mental Health. Marie Claire Roderick Psyd Llc practices in Broomfield, CO. The NPI Number for Marie Claire Roderick Psyd Llc is 1174246466 and holds a License No. (Colorado).

The current practice location address for Marie Claire Roderick Psyd Llc is 12591 Whippoorwill St, Broomfield, CO and can be reached out via phone at 571-276-8939. You can also correspond with Marie Claire Roderick Psyd Llc through the mailing address at PO BOX 756, BROOMFIELD, CO - 80038-0756 (mailing address contact number: 571-234-8106).

Location: 12591 Whippoorwill St, Broomfield, CO, 80038-0756
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1174246466
Provider Name
Marie Claire Roderick Psyd Llc
Credential
Provider Entity Type
Organization
Address
12591 Whippoorwill St, Broomfield, CO, 80038-0756
Phone Number
571-276-8939
Fax Number
Provider Enumeration Date
09/21/2022
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1851750376 01 MD NPI INDIVIDUAL NUMBER
0810005301 01 VA VA STATE LICENSE TO PRACTICE AS A CLINICAL PSYCHOLOGIST
0005553 01 CO STATE OF COLORADO STATE LICENSE TO PRACTICE CLINICAL PSYCHOLOGY
institution
Provider Business Practice Location Address Details
Address
12591 Whippoorwill St
City
Broomfield
State
Colorado
Zip
80020-7919
Phone Number
571-276-8939
Fax Number
person
Provider Business Mailing Address Details
Address
Po Box 756
City
Broomfield
State
Colorado
Zip
80038-0756
Phone Number
571-234-8106
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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