MEDICARE: CREATIVE CORE THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1154277879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE CORE THERAPY

Provider Business Mailing Address
First Line	:	8774 YATES DR STE 150
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-6964
Country	:	US
Telephone Number	:	720-295-5860
Fax Number	:

Provider Business Practice Location Address
First Line	:	8774 YATES DR STE 150
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-6964
Country	:	US
Telephone Number	:	720-295-5860
Fax Number	:

Authorized Official
Title or Position	:	OWNER AND CLINICAL DIRECTOR
Name	:	JACENTA LYNN IRLANDA
Credential	:	MA, LPC, ATR, ACS
Telephone Number	:	720-295-5860

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “CREATIVE CORE THERAPY ” Practice Location

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