MEDICARE: GRACE MULLADY

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
1	101YM0800X	Mental Health Counselor	0024376	CO

General Provider Information

NPI Number	:	1134063951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE MULLADY

Provider Business Mailing Address
First Line	:	840 S PENNSYLVANIA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 S PENNSYLVANIA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4137
Country	:	US
Telephone Number	:	512-963-7970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ GRACE MULLADY ” Practice Location

Language	Start Address	Practice Location

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