Healthcare Provider Details

I. General information

NPI: 1487577680
Provider Name (Legal Business Name): ANCHOR AND BLOOM MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

4337 TENNYSON ST UNIT 105
DENVER CO
80212-2480
US

IV. Provider business mailing address

2921 W 38TH AVE # 231
DENVER CO
80211-2019
US

V. Phone/Fax

Practice location:
  • Phone: 303-622-3669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: CHANTELLE ERICKSON
Title or Position: OWNER
Credential:
Phone: 719-650-4428