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General NPI Number Information
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NPI Number | 1548776909
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Entity Type | Individual
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Provider Name | MADISON ROSEANN RIDDLE MUSSON M.A., LMFT, ATR-BC
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Gender | Female
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 4682 BEELER CT APT 517
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City | DENVER
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State | CO
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Zip | 80238-4472
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Country | US
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Telephone | 206-556-6118
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Fax |
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Provider Business Mailing Address
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Address Line | 4682 BEELER CT APT 517
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City | DENVER
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State | CO
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Zip | 80238-4472
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Country | US
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Telephone | 206-556-6118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT.0001952
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 17-539
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 17-539
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 084849
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License Number State | IA
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