Healthcare Provider Details

I. General information

NPI: 1356694939
Provider Name (Legal Business Name): CORI WOODLAND LPC, LAC
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: CORIANDER WOODLAND LPC, LAC

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 E 12TH AVE STE 100
DENVER CO
80206-3431
US

IV. Provider business mailing address

3570 E 12TH AVE STE 100
DENVER CO
80206-3431
US

V. Phone/Fax

Practice location:
  • Phone: 720-285-7342
  • Fax:
Mailing address:
  • Phone: 720-285-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number230
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6319
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: