Provider Demographics
NPI:1740167691
Name:REDWOOD PSYCHOLOGY, PLLC
Entity type:Organization
Organization Name:REDWOOD PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POLING
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-900-1090
Mailing Address - Street 1:2995 BASELINE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2318
Mailing Address - Country:US
Mailing Address - Phone:720-900-1090
Mailing Address - Fax:
Practice Address - Street 1:2995 BASELINE RD STE 202
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2318
Practice Address - Country:US
Practice Address - Phone:720-900-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty