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General NPI Number Information
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NPI Number | 1740537919
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Entity Type | Individual
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Provider Name | NICHOLAS MANCINI M.A., LPC, LMFT
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Gender | Male
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 121 S MADISON ST SUITE D
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City | DENVER
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State | CO
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Zip | 80209
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Country | US
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Telephone | 720-663-1465
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Fax |
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Provider Business Mailing Address
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Address Line | 121 S MADISON ST STE C
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City | DENVER
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State | CO
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Zip | 80209-3019
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Country | US
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Telephone | 720-663-1465
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0012613
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT.0001416
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License Number State | CO
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