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General NPI Number Information
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NPI Number | 1144020322
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Entity Type | Organization
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Legal Business Name | HEALING FORGE THERAPY
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 13526 JACKSON ST
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City | THORNTON
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State | CO
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Zip | 80241-1463
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Country | US
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Telephone | 509-899-7199
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Fax |
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Provider Business Mailing Address
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Address Line | 13526 JACKSON ST
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City | THORNTON
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State | CO
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Zip | 80241-1463
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Country | US
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Telephone | 509-899-7199
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRED WASHBURN
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Credential | LPC
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Telephone | 970-795-2728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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