Healthcare Provider Details

I. General information

NPI: 1013838879
Provider Name (Legal Business Name): CREATE OUTCOMES PSYCHOLOGICAL ASSESSMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S JACKSON ST STE 505
DENVER CO
80209-3184
US

IV. Provider business mailing address

22 OAKWOOD RD
HUNTINGTON NY
11743-4231
US

V. Phone/Fax

Practice location:
  • Phone: 866-232-7328
  • Fax:
Mailing address:
  • Phone: 866-232-7328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL POLLET
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 866-232-7328