| Marcy Mullet Lpc Llc | |
|
5000 Butte Street 149 Boulder CO 80301 | |
| (303) 330-3589 | |
| (866) 757-5778 |
| Full Name | Marcy Mullet Lpc Llc |
|---|---|
| Speciality | Counselor |
| Location | 5000 Butte Street, Boulder, Colorado |
| Authorized Official Name and Position | Marcy M Mullet (OWNER / MBR) |
| Authorized Official Contact | 3033303589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcy Mullet Lpc Llc 5000 Butte Street 149 Boulder CO 80301 Ph: (303) 330-3589 | Marcy Mullet Lpc Llc 5000 Butte Street 149 Boulder CO 80301 Ph: (303) 330-3589 |
| NPI Number | 1699442301 |
|---|---|
| Provider Enumeration Date | 08/30/2021 |
| Last Update Date | 08/30/2021 |
| Certification Date | 08/30/2021 |
| Medicare PECOS PAC ID | 7517307176 |
|---|---|
| Medicare Enrollment ID | O20240430000502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699442301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Marcy M Mullet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083023824 PECOS PAC ID: 1850731415 Enrollment ID: I20240501001509 |
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