Healthcare Provider Details

I. General information

NPI: 1841829520
Provider Name (Legal Business Name): 4 WINDS / 5 ELEMENTS COUNSELING AND HEALING ARTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 KIPLING ST STE 204
LAKEWOOD CO
80215-1545
US

IV. Provider business mailing address

PO BOX 356
KITTREDGE CO
80457-0356
US

V. Phone/Fax

Practice location:
  • Phone: 720-520-2762
  • Fax:
Mailing address:
  • Phone: 720-520-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JANET M REICHART
Title or Position: OWNER
Credential: LCSW
Phone: 720-520-2762