Healthcare Provider Details

I. General information

NPI: 1912839077
Provider Name (Legal Business Name): GREEN COUCH COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3470 S SHERMAN ST
ENGLEWOOD CO
80113-2680
US

IV. Provider business mailing address

3470 S SHERMAN ST
ENGLEWOOD CO
80113-2680
US

V. Phone/Fax

Practice location:
  • Phone: 720-779-0351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MALLORY GOLLICK
Title or Position: PRESIDENT
Credential:
Phone: 720-779-0351