Healthcare Provider Details

I. General information

NPI: 1285597823
Provider Name (Legal Business Name): INTEGRATIVE LIFE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 S PEARL ST
DENVER CO
80210-3184
US

IV. Provider business mailing address

416 S GRANT ST
DENVER CO
80209-1727
US

V. Phone/Fax

Practice location:
  • Phone: 303-482-2026
  • Fax:
Mailing address:
  • Phone: 303-514-3592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ERICA VIGGIANO
Title or Position: OWNER
Credential: LCSW
Phone: 303-482-2026