Healthcare Provider Details

I. General information

NPI: 1740017367
Provider Name (Legal Business Name): PHOENIX ASCENDING COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9364 TEDDY LN STE 204
LONE TREE CO
80124-2873
US

IV. Provider business mailing address

9364 TEDDY LN STE 204
LONE TREE CO
80124-2873
US

V. Phone/Fax

Practice location:
  • Phone: 303-656-1154
  • Fax:
Mailing address:
  • Phone: 303-656-1154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELIZABETH WYNN
Title or Position: OWNER/CEO
Credential: LPC
Phone: 303-656-1154