Healthcare Provider Details

I. General information

NPI: 1285503441
Provider Name (Legal Business Name): PEACE OF MIND COLLABORATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 E KIOWA AVE
ELIZABETH CO
80107-7452
US

IV. Provider business mailing address

187 E KIOWA AVE
ELIZABETH CO
80107-7452
US

V. Phone/Fax

Practice location:
  • Phone: 303-418-4573
  • Fax: 303-418-4573
Mailing address:
  • Phone: 303-418-4573
  • Fax: 303-418-4573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SARA SHORT
Title or Position: PRESIDENT
Credential:
Phone: 303-418-4573