MEDICARE: MARISSA MUELLER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	390200000X	Student in an Organized Health Care Education/Training Program	NM

General Provider Information

NPI Number	:	1538772009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA MUELLER

Provider Business Mailing Address
First Line	:	2444 S YORK ST APT 403
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-5353
Country	:	US
Telephone Number	:	972-921-1130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 TULANE AVE # 8055
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2632
Country	:	US
Telephone Number	:	972-921-1130
Fax Number	:

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

Provider Enumeration Date	:	08/25/2020
Last Update Date	:	06/25/2026

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Directions to “ MARISSA MUELLER ” Practice Location

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