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General NPI Number Information
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NPI Number | 1093505638
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Entity Type | Organization
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Legal Business Name | COPPER LANTERN WELLNESS & PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1090 S WADSWORTH BLVD UNIT C3183
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City | LAKEWOOD
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State | CO
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Zip | 80226-4328
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Country | US
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Telephone | 720-679-8205
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Fax |
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Provider Business Mailing Address
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Address Line | 1090 S WADSWORTH BLVD UNIT C3183
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City | LAKEWOOD
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State | CO
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Zip | 80226-4328
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Country | US
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Telephone | 720-679-8205
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Fax |
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Authorized Official
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Title or Position | CLINICIAN - OWNER
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Name | CAREY COUZELIS
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Credential | CNM, PMHNP-BC
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Telephone | 720-679-8205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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