Provider Demographics
NPI:1841615077
Name:MAZURANIC, LINDA (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MAZURANIC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 RACINE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6322
Mailing Address - Country:US
Mailing Address - Phone:573-228-8665
Mailing Address - Fax:
Practice Address - Street 1:938 RACINE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6322
Practice Address - Country:US
Practice Address - Phone:573-228-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004014251101YP2500X
COLPC0011597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPC0011597OtherLICENSED PROFESSIONAL COUNSELOR
MO2004014251OtherLICENSED PROFESSIONAL COUNSELOR
CO74185039Medicaid