Provider Demographics
NPI:1356694939
Name:WOODLAND, CORI (LPC, LAC)
Entity type:Individual
Prefix:
First Name:CORI
Middle Name:
Last Name:WOODLAND
Suffix:
Gender:X
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:CORIANDER
Other - Middle Name:
Other - Last Name:WOODLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LAC
Mailing Address - Street 1:3570 E 12TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3431
Mailing Address - Country:US
Mailing Address - Phone:720-285-7342
Mailing Address - Fax:
Practice Address - Street 1:3570 E 12TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-3431
Practice Address - Country:US
Practice Address - Phone:720-285-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 374K00000X, 133NN1002X
CO6319101YM0800X
CO230101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171400000XOther Service ProvidersHealth & Wellness Coach
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34253734Medicaid