Healthcare Provider Details

I. General information

NPI: 1033977533
Provider Name (Legal Business Name): HUNDRED LEAF HEALING ARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 FRONT ST STE 102
LOUISVILLE CO
80027-1805
US

IV. Provider business mailing address

700 FRONT ST STE 102
LOUISVILLE CO
80027-1805
US

V. Phone/Fax

Practice location:
  • Phone: 720-507-4417
  • Fax:
Mailing address:
  • Phone: 720-507-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CAITLIN ARCE
Title or Position: OWNER, THERAPIST
Credential: LPC
Phone: 585-455-4670