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NPI Code Detail

MEDICARE: MINDFUL THERAPY GROUP OF COLORADO, P.C.

MEDICARE: MINDFUL THERAPY GROUP OF COLORADO, P.C.
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
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family Therapist
31041C0700XClinical Social Worker

General Provider Information

NPI Number : 1952285553
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDFUL THERAPY GROUP OF COLORADO, P.C.
Provider Business Mailing Address
First Line : 6505 216TH ST SW STE 100
Second Line :
City : MOUNTLAKE TERRACE
State : WA
Zip : 98043-2089
Country : US
Telephone Number : 425-640-7009
Fax Number : 425-678-6455
Provider Business Practice Location Address
First Line : 8700 TURNPIKE DR STE 400
Second Line :
City : WESTMINSTER
State : CO
Zip : 80031-7033
Country : US
Telephone Number : 720-316-6564
Fax Number : 800-377-1553
Authorized Official
Title or Position : PAYOR RELATIONSHIP MANAGER
Name : NICOLE PAULY
Credential : MHA
Telephone Number : 425-640-7009
Provider Enumeration Date : 08/05/2025
Last Update Date : 08/05/2025

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