MEDICARE: MARA ELIZABETH THORNBERG LPC, LCPC, NCC

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	83681	TX

General Provider Information

NPI Number	:	1285395251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARA ELIZABETH THORNBERG LPC, LCPC, NCC

Provider Business Mailing Address
First Line	:	1500 N GRANT ST STE R
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1859
Country	:	US
Telephone Number	:	512-661-2895
Fax Number	:	406-258-0551

Provider Business Practice Location Address
First Line	:	1500 N GRANT ST STE R
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1859
Country	:	US
Telephone Number	:	512-661-2895
Fax Number	:	406-258-0551

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

Provider Enumeration Date	:	01/03/2022
Last Update Date	:	02/10/2026

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