Healthcare Provider Details

I. General information

NPI: 1720994502
Provider Name (Legal Business Name): TEAGAN CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12211 W ALAMEDA PKWY STE 201
LAKEWOOD CO
80228-2825
US

IV. Provider business mailing address

1141 E 1ST AVE APT 1437
BROOMFIELD CO
80020-3735
US

V. Phone/Fax

Practice location:
  • Phone: 720-583-5668
  • Fax:
Mailing address:
  • Phone: 970-975-0733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0024318
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: