Healthcare Provider Details

I. General information

NPI: 1104730506
Provider Name (Legal Business Name): MELISSA KAUFMANN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12211 W ALAMEDA PKWY STE 201
LAKEWOOD CO
80228-2825
US

IV. Provider business mailing address

12211 W ALAMEDA PKWY STE 201
LAKEWOOD CO
80228-2825
US

V. Phone/Fax

Practice location:
  • Phone: 720-583-5668
  • Fax:
Mailing address:
  • Phone: 720-583-5668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: