Provider Demographics
NPI:1205110632
Name:MASLOW, NIKOLAS (MA, LPC, CGP)
Entity type:Individual
Prefix:
First Name:NIKOLAS
Middle Name:
Last Name:MASLOW
Suffix:
Gender:M
Credentials:MA, LPC, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 IRIS ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2216
Mailing Address - Country:US
Mailing Address - Phone:719-214-0004
Mailing Address - Fax:
Practice Address - Street 1:2825 MARINE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1027
Practice Address - Country:US
Practice Address - Phone:719-214-0004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional