Provider Demographics
NPI:1568912079
Name:CONGER, INDIGO (LMFT)
Entity Type:Individual
Prefix:
First Name:INDIGO
Middle Name:
Last Name:CONGER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 S BELLAIRE ST
Mailing Address - Street 2:#200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4306
Mailing Address - Country:US
Mailing Address - Phone:646-263-3683
Mailing Address - Fax:
Practice Address - Street 1:1777 S BELLAIRE ST
Practice Address - Street 2:#200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4306
Practice Address - Country:US
Practice Address - Phone:646-263-3683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001275106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist