Provider Demographics
NPI:1003688243
Name:NOWROUZI, MIRIAM (LPC)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:NOWROUZI
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 1:1575 S TENNYSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4431
Mailing Address - Country:US
Mailing Address - Phone:317-682-8061
Mailing Address - Fax:
Practice Address - Street 1:7114 W JEFFERSON AVE STE 306
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2373
Practice Address - Country:US
Practice Address - Phone:317-682-8061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
COLPC.0017706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional