Provider Demographics
NPI:1003526948
Name:INTUITIVE LIFE WELLNESS LLC
Entity Type:Organization
Organization Name:INTUITIVE LIFE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-800-1233
Mailing Address - Street 1:8344 HOLMAN ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-1498
Mailing Address - Country:US
Mailing Address - Phone:309-267-2534
Mailing Address - Fax:
Practice Address - Street 1:8344 HOLMAN ST UNIT B
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-1498
Practice Address - Country:US
Practice Address - Phone:309-267-2534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty