Healthcare Provider Details

I. General information

NPI: 1326869520
Provider Name (Legal Business Name): HANNAH MIENTKA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S CHERRY ST STE 1675
DENVER CO
80246-2532
US

IV. Provider business mailing address

950 S CHERRY ST STE 1675
DENVER CO
80246-2532
US

V. Phone/Fax

Practice location:
  • Phone: 719-232-6839
  • Fax:
Mailing address:
  • Phone: 719-232-6839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0021434
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: