Healthcare Provider Details

I. General information

NPI: 1184584112
Provider Name (Legal Business Name): A NEW LIGHT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 S COLORADO BLVD STE C304
DENVER CO
80222-3345
US

IV. Provider business mailing address

1355 S COLORADO BLVD STE C304
DENVER CO
80222-3345
US

V. Phone/Fax

Practice location:
  • Phone: 720-248-8048
  • Fax:
Mailing address:
  • Phone: 720-248-8048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JEREMY EARLE ANDERSON
Title or Position: OWNER
Credential:
Phone: 720-248-8048