Healthcare Provider Details

I. General information

NPI: 1740169028
Provider Name (Legal Business Name): MINDFUL THERAPY GROUP OF COLORADO, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 TURNPIKE DR STE 400
WESTMINSTER CO
80031-7033
US

IV. Provider business mailing address

6505 216TH ST SW STE 100
MOUNTLAKE TERRACE WA
98043-2089
US

V. Phone/Fax

Practice location:
  • Phone: 720-316-6564
  • Fax: 800-377-1553
Mailing address:
  • Phone: 425-640-7009
  • Fax: 425-678-6455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NICOLE PAULY
Title or Position: PAYOR RELATIONSHIP MANAGER
Credential: MHA
Phone: 425-640-7009