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General NPI Number Information
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NPI Number | 1154277879
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Entity Type | Organization
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Legal Business Name | CREATIVE CORE THERAPY
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 8774 YATES DR STE 150
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City | WESTMINSTER
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State | CO
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Zip | 80031-6964
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Country | US
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Telephone | 720-295-5860
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Fax |
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Provider Business Mailing Address
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Address Line | 8774 YATES DR STE 150
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City | WESTMINSTER
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State | CO
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Zip | 80031-6964
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Country | US
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Telephone | 720-295-5860
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Fax |
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Authorized Official
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Title or Position | OWNER AND CLINICAL DIRECTOR
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Name | JACENTA LYNN IRLANDA
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Credential | MA, LPC, ATR, ACS
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Telephone | 720-295-5860
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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 |
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License Number State |
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