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General NPI Number Information
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NPI Number | 1134044076
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Entity Type | Individual
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Provider Name | TIA URBAN LPCC, CAT
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 14190 E JEWELL AVE STE 7
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City | AURORA
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State | CO
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Zip | 80012-5659
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Country | US
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Telephone | 720-288-0450
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Fax |
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Provider Business Mailing Address
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Address Line | 11183 E BALTIC PL
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City | AURORA
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State | CO
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Zip | 80014-1083
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.0023751
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License Number State | CO
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