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NPI Code Detail

MEDICARE: INNER REFLECTIVE THERAPY,LLC

MEDICARE: INNER REFLECTIVE THERAPY,LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1285588459
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER REFLECTIVE THERAPY,LLC
Provider Business Mailing Address
First Line : 2020 N ACADEMY BLVD STE 355
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1567
Country : US
Telephone Number : 719-922-0362
Fax Number :
Provider Business Practice Location Address
First Line : 2020 N ACADEMY BLVD STE 355
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1567
Country : US
Telephone Number : 719-922-0362
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. PETRA WRIGHT
Credential : LPC, LAC
Telephone Number : 719-922-0362
Provider Enumeration Date : 02/24/2026
Last Update Date : 02/24/2026

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Directions to “INNER REFLECTIVE THERAPY,LLC ” Practice Location

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