Healthcare Provider Details

I. General information

NPI: 1639087901
Provider Name (Legal Business Name): MINDCLIMB THERAPY & CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 W ELIZABETH ST UNIT 14C
FORT COLLINS CO
80521-7518
US

IV. Provider business mailing address

1500 N GRANT ST # 10229
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 720-740-1737
  • Fax:
Mailing address:
  • Phone: 720-740-1737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EBONY JOHNSON
Title or Position: OWNER/LPC
Credential:
Phone: 720-740-1737