Provider Demographics
NPI:1215798244
Name:MATHIEU, MALORIE MICHELLE (LPCC)
Entity type:Individual
Prefix:
First Name:MALORIE
Middle Name:MICHELLE
Last Name:MATHIEU
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 W HAMPDEN AVE APT 2-108
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5410
Mailing Address - Country:US
Mailing Address - Phone:630-439-4660
Mailing Address - Fax:
Practice Address - Street 1:3333 S WADSWORTH BLVD UNIT D201
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5141
Practice Address - Country:US
Practice Address - Phone:630-439-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021648101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health