Healthcare Provider Details

I. General information

NPI: 1023936424
Provider Name (Legal Business Name): FORTIFYING WELLNESS INTEGRATIVE PSYCHIATRY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 S PIERCE ST STE 205
LITTLETON CO
80128-4592
US

IV. Provider business mailing address

4760 S WADSWORTH BLVD UNIT D102
DENVER CO
80123-1364
US

V. Phone/Fax

Practice location:
  • Phone: 720-432-0958
  • Fax:
Mailing address:
  • Phone: 719-661-7290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC LEE WAGNER
Title or Position: FOUNDER/PSYCHIATRIST
Credential: MD
Phone: 719-661-7290