Healthcare Provider Details

I. General information

NPI: 1114207529
Provider Name (Legal Business Name): THE CATALYST CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S JACKSON ST SUITE 520
DENVER CO
80209-3176
US

IV. Provider business mailing address

300 S JACKSON ST SUITE 520
DENVER CO
80209-3176
US

V. Phone/Fax

Practice location:
  • Phone: 720-675-7123
  • Fax:
Mailing address:
  • Phone: 720-675-7123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5947
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number11386
License Number StateCO

VIII. Authorized Official

Name: DR. ERIN JACKLIN
Title or Position: OWNER, CLINICAL DIRECTOR
Credential: PSY.D.
Phone: 720-675-7123