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NPI Code Detail

MEDICARE: MARIAH NICOLE SEVERUD BA

MEDICARE: MARIAH NICOLE SEVERUD BA
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1588389209
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAH NICOLE SEVERUD BA
Provider Business Mailing Address
First Line : 2921 W 120TH AVE UNIT 100
Second Line :
City : WESTMINSTER
State : CO
Zip : 80234-2944
Country : US
Telephone Number : 720-780-2666
Fax Number : 720-734-3078
Provider Business Practice Location Address
First Line : 2921 W 120TH AVE UNIT 100
Second Line :
City : WESTMINSTER
State : CO
Zip : 80234-2944
Country : US
Telephone Number : 720-780-2666
Fax Number : 720-734-3078
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2022
Last Update Date : 10/08/2025

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Directions to “ MARIAH NICOLE SEVERUD BA” Practice Location

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