Centered Wellness Therapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CENTERED WELLNESS THERAPY PLLC

Practice address

390 S Potomac Way Ste C
Aurora, CO 80012-2491

Phone

(720) 803-1968

NPI assigned

Mar 4, 2024

Last updated

Mar 4, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emilia Broadhurst Ealom, LCSW, LACNPI 1588063978

Title

Owner

Phone

(720) 803-1968

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emilia Broadhurst Ealom, LCSW

  • Clinical Social Worker
  • Wheat Ridge, CO
  • NPI 1588063978
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1225895592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4382 W RICE PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802363451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 S POTOMAC WAY STE C",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122491",
            "telephone_number": "720-803-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERED WELLNESS THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "EALOM",
        "authorized_official_first_name": "EMILIA",
        "authorized_official_middle_name": "BROADHURST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-803-1968",
        "authorized_official_credential": "LCSW, LAC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.