Provider Demographics
NPI:1346614708
Name:MALCOLM, MAUREEN (MA)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:MALCOLM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 W 58TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2249
Mailing Address - Country:US
Mailing Address - Phone:303-335-5630
Mailing Address - Fax:
Practice Address - Street 1:8800 W 58TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2249
Practice Address - Country:US
Practice Address - Phone:303-335-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0105720101YM0800X
COLPC.0015411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health