Provider Demographics
NPI:1316814551
Name:CDOC
Entity type:Organization
Organization Name:CDOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SWIII
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:LCP, MAET
Authorized Official - Phone:303-304-2334
Mailing Address - Street 1:10900 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3262
Mailing Address - Country:US
Mailing Address - Phone:303-304-2334
Mailing Address - Fax:
Practice Address - Street 1:10900 SMITH RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-3262
Practice Address - Country:US
Practice Address - Phone:303-304-2334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CDOC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty