Healthcare Provider Details

I. General information

NPI: 1902793482
Provider Name (Legal Business Name): FULL LIFE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 S JACKSON ST STE 505
DENVER CO
80210-3817
US

IV. Provider business mailing address

1776 S JACKSON ST STE 505
DENVER CO
80210-3817
US

V. Phone/Fax

Practice location:
  • Phone: 720-460-1878
  • Fax:
Mailing address:
  • Phone: 720-460-1878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURA PHELPS
Title or Position: OWNER
Credential: MA, LPC
Phone: 720-460-1878