Healthcare Provider Details

I. General information

NPI: 1114853173
Provider Name (Legal Business Name): PRISM RELATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22381 E 38TH PL
AURORA CO
80019-3678
US

IV. Provider business mailing address

22381 E 38TH PL
AURORA CO
80019-3678
US

V. Phone/Fax

Practice location:
  • Phone: 720-295-2145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER OGLESBY
Title or Position: THERAPIST
Credential: LMFT, LPC
Phone: 720-288-6697