Healthcare Provider Details

I. General information

NPI: 1144864943
Provider Name (Legal Business Name): CONIFER PLAY THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10791 KITTY DR STE A
CONIFER CO
80433-7748
US

IV. Provider business mailing address

10791 KITTY DR STE A
CONIFER CO
80433-7748
US

V. Phone/Fax

Practice location:
  • Phone: 720-281-9789
  • Fax:
Mailing address:
  • Phone: 720-281-9789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LAUREN FERGUSON
Title or Position: OWNER
Credential: LMFT
Phone: 720-323-9219