Healthcare Provider Details

I. General information

NPI: 1679367957
Provider Name (Legal Business Name): MARTTA ENSIO LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 E PRENTICE AVE STE B2
GREENWOOD VILLAGE CO
80111-2726
US

IV. Provider business mailing address

2558 CENTRAL PARK BLVD
DENVER CO
80238-2743
US

V. Phone/Fax

Practice location:
  • Phone: 520-243-0443
  • Fax:
Mailing address:
  • Phone: 520-243-0443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022298
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: