Healthcare Provider Details

I. General information

NPI: 1750240636
Provider Name (Legal Business Name): COLLECTIVE HEALING INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 NAVAJO ST
TRINIDAD CO
81082-2230
US

IV. Provider business mailing address

809 NAVAJO ST
TRINIDAD CO
81082-2230
US

V. Phone/Fax

Practice location:
  • Phone: 303-335-0927
  • Fax:
Mailing address:
  • Phone:
  • 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: ISHA LUCAS
Title or Position: DIRECTOR
Credential: PHD, LPC
Phone: 303-335-0927