Healthcare Provider Details

I. General information

NPI: 1023938180
Provider Name (Legal Business Name): WILD CRESCENT THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1556 N WILLIAMS ST UNIT 201
DENVER CO
80218-1661
US

IV. Provider business mailing address

1556 N WILLIAMS ST UNIT 201
DENVER CO
80218-1661
US

V. Phone/Fax

Practice location:
  • Phone: 720-277-9186
  • Fax:
Mailing address:
  • Phone: 720-277-9186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MEAGHAN SEELAUS
Title or Position: OWNER/LEAD PSYCHOTHERAPIST
Credential: LPCC
Phone: 720-277-9186