Healthcare Provider Details

I. General information

NPI: 1437035623
Provider Name (Legal Business Name): KENOSIS COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S ONEIDA ST STE 107
DENVER CO
80224-2550
US

IV. Provider business mailing address

2770 ARAPAHOE RD STE 132-1027
LAFAYETTE CO
80026-8018
US

V. Phone/Fax

Practice location:
  • Phone: 303-785-9943
  • Fax:
Mailing address:
  • Phone: 303-785-9943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ROCHELLE RADDATZ
Title or Position: OWNER/CLINICIAN
Credential:
Phone: 303-883-0429