| Finding Hiawatha, Pllc | |
|
1255 Lee St Lakewood CO 80215-4542 | |
| (720) 530-7579 | |
| Not Available |
| Full Name | Finding Hiawatha, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1255 Lee St, Lakewood, Colorado |
| Authorized Official Name and Position | Jacqueline Maben (OWNER) |
| Authorized Official Contact | 7205307579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Finding Hiawatha, Pllc 1255 Lee St Lakewood CO 80215-4542 Ph: (720) 530-7579 | Finding Hiawatha, Pllc 1255 Lee St Lakewood CO 80215-4542 Ph: (720) 530-7579 |
| NPI Number | 1932726916 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 06/28/2024 |
| Certification Date | 06/28/2024 |
| Medicare PECOS PAC ID | 1254875230 |
|---|---|
| Medicare Enrollment ID | O20240701003861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932726916 | NPI | - | NPPES |
| 1447709308 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Leigh Maben |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447709308 PECOS PAC ID: 2163966144 Enrollment ID: I20240701003903 |
| Provider Name | Caitlin Zoghby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447945217 PECOS PAC ID: 4082158985 Enrollment ID: I20240702004377 |
| Provider Name | Katie Michelle Keotunian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669078358 PECOS PAC ID: 9436693330 Enrollment ID: I20240702004415 |
| Provider Name | Erin Kathleen Peterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386406213 PECOS PAC ID: 0244774149 Enrollment ID: I20240702004449 |
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