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NPI Code Detail

MEDICARE: MARIBETH EILEEN FLANAGAN LPC

MEDICARE: MARIBETH EILEEN FLANAGAN LPC
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
1101YP2500XProfessional Counselor3019CO

General Provider Information

NPI Number : 1073573457
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIBETH EILEEN FLANAGAN LPC
Provider Business Mailing Address
First Line : 4851 INDEPENDENCE ST
Second Line : SUITE 200
City : WHEAT RIDGE
State : CO
Zip : 80033-6715
Country : US
Telephone Number : 303-432-5101
Fax Number :
Provider Business Practice Location Address
First Line : 4851 INDEPENDENCE ST
Second Line : SUITE 200
City : WHEAT RIDGE
State : CO
Zip : 80033-6715
Country : US
Telephone Number : 303-432-5101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 07/08/2007

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