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General NPI Number Information
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NPI Number | 1831005644
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Entity Type | Individual
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Provider Name | DENISE JANE ITULE LAC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 2519 S SHIELDS STREET SUITE 1K #815
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City | FORT COLLINS
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State | CO
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Zip | 80526-4134
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Country | US
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Telephone | 970-481-9648
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Fax |
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Provider Business Mailing Address
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Address Line | 2519 S SHIELDS ST STE 1K
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City | FORT COLLINS
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State | CO
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Zip | 80526-1855
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Country | US
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Telephone | 970-481-9648
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0003037
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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 | LPCC.0021826
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License Number State | CO
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