Healthcare Provider Details

I. General information

NPI: 1952287385
Provider Name (Legal Business Name): IGNITE COUNSELING COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4380 S SYRACUSE ST STE 320
DENVER CO
80237-2420
US

IV. Provider business mailing address

4380 S SYRACUSE ST STE 320
DENVER CO
80237-2420
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-6336
  • Fax:
Mailing address:
  • Phone:
  • 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: MARIAH COFFEE
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 303-578-6336