Provider Demographics
NPI:1073658548
Name:CACACE, MAUREEN ANNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ANNE
Last Name:CACACE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6093 S QUEBEC ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4542
Mailing Address - Country:US
Mailing Address - Phone:720-971-1665
Mailing Address - Fax:303-586-6075
Practice Address - Street 1:6093 S QUEBEC ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4542
Practice Address - Country:US
Practice Address - Phone:720-971-1665
Practice Address - Fax:303-586-6075
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO899106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004266575Medicaid
CO11711474OtherCAQH