| Marcie L Mata, Lpc, Llc | |
|
109 Coronado Ct Bldg 7 Fort Collins CO 80525-4929 | |
| (970) 308-4474 | |
| (970) 377-6767 |
| Full Name | Marcie L Mata, Lpc, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 109 Coronado Ct Bldg 7, Fort Collins, Colorado |
| Authorized Official Name and Position | Marcie Lynn Mata (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9703084474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcie L Mata, Lpc, Llc 109 Coronado Ct Bldg 7 Fort Collins CO 80525-4929 Ph: (970) 308-4474 | Marcie L Mata, Lpc, Llc 109 Coronado Ct Bldg 7 Fort Collins CO 80525-4929 Ph: (970) 308-4474 |
| NPI Number | 1952752131 |
|---|---|
| Provider Enumeration Date | 06/28/2016 |
| Last Update Date | 06/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952752131 | NPI | - | NPPES |
| 24785229 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4971 (Colorado) | Primary |
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