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Emergence Psychedelic Therapy, LLC

NPI 1407723497ActiveOrganization· Clinic/Center· Boulder, CO

Clinic/Center in Boulder, Colorado, registered in NPPES in October 2025. The authorized official on file is Stacy Green, MD, Owner.

Overview

NPI1407723497
StatusActive
Entity typeOrganization
NPI issuedOct 22, 2025
Last updated in NPPESJan 23, 2026
Certified by providerJan 23, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Clinic/Center Primary261Q00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Clinic/Center providers in Boulder

All 29 Clinic/Center providers in Boulder · All Clinic/Center providers in Colorado