MEDICARE: CAROL MASCARENHAS

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	106H00000X	Marriage & Family Therapist	NLC.0106183	CO

General Provider Information

NPI Number	:	1619414000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MASCARENHAS

Provider Business Mailing Address
First Line	:	2749 S HARRISON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-6629
Country	:	US
Telephone Number	:	303-748-4071
Fax Number	:

Provider Business Practice Location Address
First Line	:	2749 S HARRISON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-6629
Country	:	US
Telephone Number	:	303-748-4071
Fax Number	:

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

Provider Enumeration Date	:	01/24/2017
Last Update Date	:	01/24/2017

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Directions to “ CAROL MASCARENHAS ” Practice Location

Language	Start Address	Practice Location

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