MEDICARE: SOPHIA MATTINGLY LPCC

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		CO

General Provider Information

NPI Number	:	1841121589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA MATTINGLY LPCC

Provider Business Mailing Address
First Line	:	17071 E ABERDEEN DR
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-3225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	671 N GRANT ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3506
Country	:	US
Telephone Number	:	720-445-9979
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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