Provider Demographics
NPI:1467203802
Name:DEFEE, MARK P (LPC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:P
Last Name:DEFEE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 39095
Mailing Address - Street 2:4710 NOME STREET
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2897 IRONTON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3214
Practice Address - Country:US
Practice Address - Phone:303-725-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health