MEDICARE: NATALIE LYNN PEPPERCORN MFTC

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	101YP2500X	Professional Counselor	LPC.0022994	CO
2	106H00000X	Marriage & Family Therapist	MFTC.0014404	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MFTC.0014404	OTHER	CO	MARRIAGE AND FAMILY THERAPY CANDIDACY LICENSE
2	LPC.0022994	OTHER	CO	LPC

General Provider Information

NPI Number	:	1588376289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE LYNN PEPPERCORN MFTC

Provider Business Mailing Address
First Line	:	3028 S ELATI ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-1443
Country	:	US
Telephone Number	:	303-522-3715
Fax Number	:

Provider Business Practice Location Address
First Line	:	8380 ZUNI ST STE 300
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-4689
Country	:	US
Telephone Number	:	970-430-5174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2022
Last Update Date	:	06/04/2026

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