Healthcare Provider Details

I. General information

NPI: 1659578599
Provider Name (Legal Business Name): CLEAN AND CLEAR MINDED CCM COUNSELING LLC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9035 WADSWORTH PKWY SUITE #2750
WESTMINSTER CO
80021-8634
US

IV. Provider business mailing address

1827 QUAIL ST APT 9
LAKEWOOD CO
80215-2735
US

V. Phone/Fax

Practice location:
  • Phone: 303-638-8131
  • Fax: 720-222-8786
Mailing address:
  • Phone: 303-638-8131
  • Fax: 720-222-8786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5437
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number989983
License Number StateCO

VIII. Authorized Official

Name: MRS. CRYSTAL CAMPBELL MESSER
Title or Position: OWNER-THERAPIST
Credential: LCSW CAC III
Phone: 303-638-8131