Healthcare Provider Details

I. General information

NPI: 1598684193
Provider Name (Legal Business Name): 1 LIFE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 QUARTZ CT
LONGMONT CO
80504-3933
US

IV. Provider business mailing address

928 QUARTZ CT
LONGMONT CO
80504-3933
US

V. Phone/Fax

Practice location:
  • Phone: 720-727-4012
  • Fax:
Mailing address:
  • Phone: 720-727-4012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAMES EDWARD GIBSON
Title or Position: OWNER- COUNSELOR
Credential: LPC
Phone: 720-727-4012