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General NPI Number Information
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NPI Number | 1891502753
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Entity Type | Organization
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Legal Business Name | MAJESTIC MOUNTAIN MENTAL HEALTH LLC
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Dates
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Enumeration Date | 12/14/2024
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 405 W BOWMAN AVE
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City | WOODLAND PARK
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State | CO
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Zip | 80863-5010
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Country | US
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Telephone | 719-212-1928
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Fax | 719-888-1866
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Provider Business Mailing Address
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Address Line | 1580 N LOGAN ST STE 660 #281714
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City | DENVER
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State | CO
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Zip | 80203
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Country | US
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Telephone | 719-212-1928
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Fax | 719-888-1866
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Authorized Official
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Title or Position | OWNER
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Name | KATHY MICHELLE CRAWFORD
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Credential | MSN, APN, PMHNP-BC
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Telephone | 719-212-1928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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