Healthcare Provider Details

I. General information

NPI: 1538964101
Provider Name (Legal Business Name): CREATIVE REFLECTIONS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11990 GRANT ST STE 550
NORTHGLENN CO
80233-1101
US

IV. Provider business mailing address

483 E 111TH PL
NORTHGLENN CO
80233-3073
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-0611
  • Fax: 983-203-9544
Mailing address:
  • Phone: 303-725-0996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DOROTHY ROGOWSKI
Title or Position: CEO
Credential: LPC
Phone: 303-725-0996