Organization
MY HEALING SPACE COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FANNIE SHARIEE JOHNSON (OWNER)
(720) 829-4471
Entity
Organization
Contact information
Practice address
14211 E 4TH AVE # 3-250, AURORA, CO 80011-8736
(720) 209-8897
Mailing address
19549 RANDOLPH PL, DENVER, CO 80249-8609
(720) 829-4471
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
04/03/2024
Last updated
06/17/2026
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