Healthcare Provider Details
I. General information
NPI: 1942176185
Provider Name (Legal Business Name): CONSCIOUS PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950 S CHERRY ST STE 1675
DENVER CO
80246-2532
US
IV. Provider business mailing address
950 S CHERRY ST STE 1675
DENVER CO
80246-2532
US
V. Phone/Fax
- Phone: 303-558-6592
- Fax: 720-637-6635
- Phone: 303-558-6592
- Fax: 720-637-6635
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JORDAN
GOUGH
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 252-256-1692