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NPI Code Detail

MEDICARE: MAXIMILIAN STEPHEN MARKO MS, LPCC

MEDICARE: MAXIMILIAN STEPHEN MARKO MS, LPCC
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
1101YP2500XProfessional CounselorLPCC.0022161CO

General Provider Information

NPI Number : 1780421735
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAXIMILIAN STEPHEN MARKO MS, LPCC
Provider Business Mailing Address
First Line : 4803 INNOVATION DR STE 3A
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-7308
Country : US
Telephone Number : 970-310-3406
Fax Number :
Provider Business Practice Location Address
First Line : 4803 INNOVATION DR STE 3A
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-7308
Country : US
Telephone Number : 970-310-3406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2024
Last Update Date : 01/21/2026

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