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General NPI Number Information
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NPI Number | 1861917056
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Entity Type | Organization
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Legal Business Name | MOUNTAIN MIND, LLC
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1863 WAZEE ST APT 1G
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City | DENVER
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State | CO
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Zip | 80202-1248
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Country | US
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Telephone | 303-808-8816
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Fax |
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Provider Business Mailing Address
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Address Line | 1863 WAZEE ST APT 1G
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City | DENVER
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State | CO
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Zip | 80202-1248
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Country | US
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Telephone | 720-788-6068
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Fax | 719-207-4464
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH A YORK
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Credential | MSN, PMHNP-BC, APRN
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Telephone | 720-788-6068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0993185
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License Number State | CO
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