NPIMap

Organization Active NPI

Cottonwood Creek Wellness Center

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1073023974
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3567 Issued in CO
Legal business name
COTTONWOOD CREEK WELLNESS CENTER
Practice address
3210 E. Woodmen Rd.
110
Colorado Springs, CO 80920
Phone
(719) 445-6744
NPI assigned
Oct 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angie Dunn, PH.D.
Title
Ceo/Clinical Director
Phone
(719) 445-6744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 3567 CO Primary

Addresses

Primary practice location

3210 E. Woodmen Rd.
110
Colorado Springs, CO 80920

Mailing address

20219 High Pines Dr
Monument, CO 80132-8383
Phone (303) 888-1021

Other identifiers 1

IdentifierTypeStateIssuer
12452965OtherNPI

National Provider Directory

National Provider Directory

Locations

219 W Colorado Ave
Ste 212
Colorado Springs, CO 80903
Phone (719) 445-6744

3280 E Woodmen Rd
Ste 200
Colorado Springs, CO 80920
Phone (719) 445-6744

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1073023974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20219 HIGH PINES DR",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801328383",
            "telephone_number": "303-888-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 E. WOODMEN RD.",
            "address_2": "110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-445-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD CREEK WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "CEO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "719-445-6744",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "12452965",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.