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General NPI Number Information
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NPI Number | 1114207529
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Entity Type | Organization
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Legal Business Name | THE CATALYST CENTER, LLC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 300 S JACKSON ST SUITE 520
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City | DENVER
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State | CO
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Zip | 80209-3176
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Country | US
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Telephone | 720-675-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S JACKSON ST SUITE 520
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City | DENVER
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State | CO
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Zip | 80209-3176
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Country | US
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Telephone | 720-675-7123
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | DR. ERIN JACKLIN
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Credential | PSY.D.
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Telephone | 720-675-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 11386
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5947
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License Number State | CO
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