Healthcare Provider Details

I. General information

NPI: 1083438576
Provider Name (Legal Business Name): INSIGHTFUL HEALING THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 S MAIN ST
ELIZABETH CO
80107-7572
US

IV. Provider business mailing address

19550 E DICKENSON PL
AURORA CO
80013-7683
US

V. Phone/Fax

Practice location:
  • Phone: 720-675-0252
  • Fax:
Mailing address:
  • Phone: 720-675-0252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ROSE STOKES
Title or Position: OWNER
Credential: MFTC
Phone: 720-675-0252