MEDICARE: CARLI MAE STANDEN

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	11924236-6004	UT
2	101YM0800X	Mental Health Counselor	LPC.0019269	CO

General Provider Information

NPI Number	:	1801401716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLI MAE STANDEN

Provider Business Mailing Address
First Line	:	720 S RIVER RD STE B105
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84790-5704
Country	:	US
Telephone Number	:	435-278-8227
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 E MOUNTAIN AVE STE 215
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-2863
Country	:	US
Telephone Number	:	970-658-9925
Fax Number	:

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

Provider Enumeration Date	:	09/09/2020
Last Update Date	:	04/16/2026

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Directions to “ CARLI MAE STANDEN ” Practice Location

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