Healthcare Provider Details
I. General information
NPI: 1518891530
Provider Name (Legal Business Name): INNER DOOR THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8795 RALSTON RD STE 114B
ARVADA CO
80002-2378
US
IV. Provider business mailing address
8795 RALSTON RD STE 114B
ARVADA CO
80002-2378
US
V. Phone/Fax
- Phone: 224-377-0390
- Fax:
- Phone: 224-377-0390
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
JESSICA
SUSANNE
KIRCHBERG
Title or Position: PSYCHOTHERAPIST AND PRACTICE OWNER
Credential: MA, LPC, LCPC
Phone: 224-377-0390