MEDICARE: INTUITIVE LIFE WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1003526948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTUITIVE LIFE WELLNESS LLC

Provider Business Mailing Address
First Line	:	1415 CRETE CT APT E
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-2834
Country	:	US
Telephone Number	:	719-800-1233
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 CRETE CT APT E
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-2834
Country	:	US
Telephone Number	:	309-267-2534
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PSYCHOTHERAPIST
Name	:	JESSICA EDEN
Credential	:	LCSW
Telephone Number	:	719-800-1233

Provider Enumeration Date	:	12/01/2022
Last Update Date	:	03/23/2026

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