MEDICARE: CREATIVE TREATMENT OPTIONS, INC.

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1407464027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE TREATMENT OPTIONS, INC.

Provider Business Mailing Address
First Line	:	7190 COLORADO BLVD STE 340
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-1808
Country	:	US
Telephone Number	:	303-467-2624
Fax Number	:	303-431-8410

Provider Business Practice Location Address
First Line	:	7190 COLORADO BLVD STE 340
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-1808
Country	:	US
Telephone Number	:	303-467-2624
Fax Number	:	303-431-8410

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	JOYCE L SMITH
Credential	:	PSYD, LAC, LPC
Telephone Number	:	303-467-2624

Provider Enumeration Date	:	07/20/2020
Last Update Date	:	09/08/2020

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