Healthcare Provider Details

I. General information

NPI: 1285395251
Provider Name (Legal Business Name): MARA ELIZABETH THORNBERG LPC, LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARAH ELIZABETH MARTINEZ

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

IV. Provider business mailing address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 512-661-2895
  • Fax: 406-258-0551
Mailing address:
  • Phone: 512-661-2895
  • Fax: 406-258-0551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number83681
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: