Healthcare Provider Details

I. General information

NPI: 1851256812
Provider Name (Legal Business Name): MELISSA JOY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 OAKRIDGE DR STE 100
FORT COLLINS CO
80525-7338
US

IV. Provider business mailing address

1854 CORRIEDALE DR
FORT COLLINS CO
80526-1103
US

V. Phone/Fax

Practice location:
  • Phone: 970-381-2676
  • Fax:
Mailing address:
  • Phone:
  • 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
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ROOT
Title or Position: FOUNDER/THERAPIST
Credential: MA, LPC
Phone: 970-381-2676