CAMILLA B GRANGER (NPI# 1164968657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164968657 |
| Entity Type | Individual |
| Full Name | CAMILLA B GRANGER |
| Credential | BA, CAC III, NCAC II |
| Practice Address |
4485 Wadsworth. Blvd 206 Wheat Ridge CO 80033-3310 |
| Mailing Address |
2435 Kline St Lakewood CO 80215-1425 |
| Practice Telephone | 3034315664 |
| Practice Fax Number | 3034316713 |
| Mailing Telephone | 3036698427 |
| Mailing Fax Number | 3039971948 |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 2085 | CO | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2085 | CO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 03685039 | 05 |
| Street Address |
4485 WADSWORTH. BLVD 206 |
| City | WHEAT RIDGE |
| State | CO |
| Zip Code | 80033-3310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893915 | Bronwyn Hockersmith | Counselor | 3954 Yosemite St, Wheat Ridge, CO 80033 | 2018-12-18 |
| 1902392004 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 4891 Independence St Ste 285, Wheat Ridge, CO 80033 | 2018-07-02 |
| 1528586120 | Front Range Family Resource Center | Marriage & Family Therapist | 5181 Ward St Ste 201, Wheat Ridge, CO 80033 | 2017-09-03 |
| 1962920918 | Dianna Lee Cordero | Counselor | 4931 Garrison St., Apt 104, Wheat Ridge, CO 80033 | 2017-08-30 |
| 1396261525 | Lauren Faye Petasne | Nurse Practitioner | 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 | 2017-08-18 |
| 1558802421 | Elizabeth Ann Huddleston | Nurse Practitioner | 3400 N Lutheran Pkwy, Wheat Ridge, CO 80033 | 2017-03-13 |
| 1053777045 | Richard Kerry Brandow | Counselor | 16625 W 50th Ave., Golden, CO 80033 | 2016-01-07 |
| 1831562131 | Eternal Life Care Centers, LLC | Assisted Living Facility | 4370 Ingalls Street, Wheat Ridge, CO 80033 | 2015-11-09 |
| 1740663483 | Real Care, Inc. | Private Vehicle | 10200 West 44th Ave, Suite 200, Wheat Ridge, CO 80033 | 2015-06-30 |
| 1508254848 | Pamela June Weitzel | Midwife | 3555 Lutheran Parkway Suite 210, Wheat Ridge, CO 80033 | 2015-01-08 |
| Find all providers in zip 80033 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821365065 | Erin R Mcdonald | Counselor | 4815 Independence St., #200, Wheat Ridge, CO 80033 | 2011-11-16 |
| 1205154374 | Michelle Lee Flake | Counselor | 4643 Wadsworth Blvd, Wheat Ridge, CO 80033-3305 | 2010-05-13 |
| 1538483805 | Charity Grimsley-hinkley | Counselor | 4045 Wadsworth Blvd Ste 306, Wheat Ridge, CO 80033-4626 | 2010-03-16 |
| 1679728067 | Sarah Michelle Zubrin | Counselor | 3000 Youngfield St Ste 390, Wheat Ridge, CO 80215-6553 | 2008-11-26 |
| 1689824815 | Nancy Ann Gunzner | Counselor | 4251 Kipling St Unit 240, Wheat Ridge, CO 80033-6838 | 2008-09-24 |
| 1982732426 | Deidrea Marcella Anderson | Counselor | 9595 W 49th Ave, Wheat Ridge, CO 80033-2279 | 2007-02-28 |
| 1205448297 | Sara Leatherwood | Counselor | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2020-08-20 |
| 1841800141 | Samantha Luisa Ardoin | Counselor | 4643 Wadsworth Blvd, Wheat Ridge, CO 80033-3305 | 2020-08-03 |
| 1619585098 | Samantha Manning | Counselor | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2020-07-21 |
| 1235757584 | Victoria Ann Kuhlman Kilway | Counselor | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2020-07-13 |
| Find all providers in WHEAT RIDGE | ||||
| City | WHEAT RIDGE |
| Zip Code | 80033 |
Please comment or provide details below to improve the information on CAMILLA B GRANGER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.