Healthcare Provider Details

I. General information

NPI: 1407704281
Provider Name (Legal Business Name): LINDSEY ANNE WISE MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 S PECOS ST
DENVER CO
80223-2621
US

IV. Provider business mailing address

839 S PECOS ST
DENVER CO
80223-2621
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-8613
  • Fax:
Mailing address:
  • Phone: 303-578-8613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0019196
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: