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NPI Code Detail

MEDICARE: HARMONIOUS MENTAL HEALTH, PLLC

MEDICARE: HARMONIOUS MENTAL HEALTH, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1063286912
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARMONIOUS MENTAL HEALTH, PLLC
Provider Business Mailing Address
First Line : 4419 CENTENNIAL BLVD UNIT 506
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-3739
Country : US
Telephone Number : 719-900-2481
Fax Number : 719-900-2483
Provider Business Practice Location Address
First Line : 3060 N ACADEMY BLVD STE 300
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5349
Country : US
Telephone Number : 719-900-2481
Fax Number : 719-900-2483
Authorized Official
Title or Position : OWNER
Name : JESSICA LAUREN MAMULA
Credential : APRN, PMHNP-BC
Telephone Number : 719-900-2481
Provider Enumeration Date : 11/10/2023
Last Update Date : 05/08/2024

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