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General NPI Number Information
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NPI Number | 1891515615
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Entity Type | Organization
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Legal Business Name | LA RAIZ THERAPY SERVICES
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 02/02/2025
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Provider Practice Location Address
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Address Line | 1370 S ELIOT ST
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City | DENVER
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State | CO
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Zip | 80219-4248
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Country | US
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Telephone | 720-767-2264
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Fax |
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Provider Business Mailing Address
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Address Line | 1370 S ELIOT ST
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City | DENVER
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State | CO
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Zip | 80219-4248
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Country | US
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Telephone | 720-767-2264
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORK
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Name | KARLA CARRANZA
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Credential | LCSW, LAC
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Telephone | 970-213-5956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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