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General NPI Number Information
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NPI Number | 1518326305
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Entity Type | Organization
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Legal Business Name | INTEGRATED WELLNESS AND STRATEGIES, LLC
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 11001 W 120TH AVE SUITE 400
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City | BROOMFIELD
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State | CO
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Zip | 80021-3494
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Country | US
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Telephone | 720-644-6378
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Fax | 720-446-3520
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Provider Business Mailing Address
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Address Line | PO BOX 155
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City | BROOMFIELD
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State | CO
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Zip | 80038-0155
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Country | US
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Telephone | 720-644-6378
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Fax | 720-446-3520
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Authorized Official
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Title or Position | OWNER
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Name | AMBER WOLFE PEARSON
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Credential | LPC
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Telephone | 720-644-6378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-6479
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License Number State | CO
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