Organization
EMPOWERED LIVING COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANAHITA LAKE-KHOSRAVI PSYD (CO-OWNER)
(720) 248-8633
Entity
Organization
Contact information
Practice address
8354 E NORTHFIELD BLVD STE 314, DENVER, CO 80238-3131
(720) 248-8633
Mailing address
8354 NORTHFIELD BLVD, BUILDING G SUITE 3700, DENVER, CO 80238-3131
(720) 248-8633
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000210453
—
CO
Enumeration date
11/30/2022
Last updated
01/09/2023
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