Healthcare Provider Details
I. General information
NPI: 1013771526
Provider Name (Legal Business Name): PURE POTENTIAL THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7600 E ARAPAHOE RD STE 114
CENTENNIAL CO
80112-1261
US
IV. Provider business mailing address
7600 E ARAPAHOE RD STE 114
CENTENNIAL CO
80112-1261
US
V. Phone/Fax
- Phone: 720-295-9772
- Fax:
- Phone: 303-881-3377
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
HALE
Title or Position: OWNDER
Credential: LMFT
Phone: 303-881-3377